Cost-effectiveness analysis of human-centred design for global health interventions: a quantitative framework.
Cost-effectiveness analysis of human-centred design for global health interventions: a quantitative framework.
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DOI：
10.1136/bmjgh-2021-007912
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发表时间：
2022-03
影响因子：
8.1
通讯作者：
Dowdy D
中科院分区：
文献类型：
--
作者：
Liu C;Lee JH;Gupta AJ;Tucker A;Larkin C;Turimumahoro P;Katamba A;Davis JL;Dowdy D
以人为本的设计（HCD）是一种解决问题的方法，越来越多地用于开发新的全球卫生干预措施。然而，HCD的初始成本往往很高，全球卫生决策者将受益于更好地了解HCD的成本效益，特别是设计的前期成本和提供卫生干预措施的长期成本之间的权衡。我们从卫生系统的角度开发了一个定量框架，以说明HCD知情干预措施可能具有成本效益的条件，考虑到五个要素：HCD成本，每个客户的干预成本，预期达到的客户数量，预期增量每个客户的健康效益（即，避免残疾调整生命年（DIOs））和支付意愿。我们评估了几种固定和实施成本方案的组合，这些方案是基于乌干达2年内对结核病（TB）接触者调查的HCD知情方法的估计成本，以说明该框架的使用。在乌干达，根据HCD进行的结核病接触者调查的成本效益估计从8，400美元（覆盖2，400名客户，HCD成本估计较低）到避免的每DALY 306，000美元（覆盖120名客户，基线HCD成本估计）不等。在我们的模型中，当干预措施预期具有更广泛的覆盖面或更高的每个客户的健康效益时，成本效益进一步提高。如果用于宣传预期将惠及大量客户的干预措施，或者在干预措施本身的成本低于干预措施本身的成本的情况下，人道主义内容说明可以具有成本效益。
Human-centred design (HCD) is a problem-solving approach that is increasingly used to develop new global health interventions. However, there is often a large initial cost associated with HCD, and global health decision-makers would benefit from an improved understanding of the cost-effectiveness of HCD, particularly the trade-offs between the up-front costs of design and the long-term costs of delivering health interventions. We developed a quantitative framework from a health systems perspective to illustrate the conditions under which HCD-informed interventions are likely to be cost-effective, taking into consideration five elements: cost of HCD, per-client intervention cost, anticipated number of clients reached, anticipated incremental per-client health benefit (ie, disability-adjusted life years (DALYs) averted) and willingness-to-pay. We evaluated several combinations of fixed and implementation cost scenarios based on the estimated costs of an HCD-informed approach to tuberculosis (TB) contact investigation in Uganda over a 2-year period to illustrate the use of this framework. The cost-effectiveness of HCD-informed TB contact investigation in Uganda was estimated to vary from US$8400 (2400 clients reached, lower HCD cost estimate) to US$306 000 per DALY averted (120 clients reached, baseline HCD cost estimate). In our model, cost-effectiveness was improved further when the interventions were expected to have wider reach or higher per-client health benefits. HCD can be cost-effective when used to inform interventions that are anticipated to reach a large number of clients, or in which the cost of HCD is smaller relative to the cost of delivering the intervention itself.
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影响因子：
9.3
作者：
Azman AS;Golub JE;Dowdy DW
通讯作者：
Dowdy DW
DOI：
10.1183/09031936.00070812
发表时间：
2013-01
期刊：
The European respiratory journal
影响因子：
--
作者：
Fox GJ;Barry SE;Britton WJ;Marks GB
通讯作者：
Marks GB
影响因子：
11.1
作者：
Marseille E;Larson B;Kazi DS;Kahn JG;Rosen S
通讯作者：
Rosen S
DOI：
10.1016/s2214-109x(21)00034-6
发表时间：
2021-05
期刊：
The Lancet. Global health
影响因子：
--
作者：
Thomas R;Probert WJM;Sauter R;Mwenge L;Singh S;Kanema S;Vanqa N;Harper A;Burger R;Cori A;Pickles M;Bell-Mandla N;Yang B;Bwalya J;Phiri M;Shanaube K;Floyd S;Donnell D;Bock P;Ayles H;Fidler S;Hayes RJ;Fraser C;Hauck K;HPTN 071 (PopART) study team
通讯作者：
HPTN 071 (PopART) study team
影响因子：
5.2
作者：
Powell, Byron J.;Fernandez, Maria E.;Weiner, Bryan J.
通讯作者：
Weiner, Bryan J.