Recurrent costs of HIV/AIDS‐related health services in Rwanda: implications for financing

Quentin, Wilm; König, Hans‐Helmut; Schmidt, Jean-Olivier; Kalk, Andreas

doi:10.1111/j.1365-3156.2008.02142.x

Cited by 9 publications

(5 citation statements)

References 17 publications

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“…First, the previous studies rarely took inputs (i.e., expenses of health facilities) into consideration when evaluating these two policies. By including inputs in the evaluation, the study can assess whether and how these policies improve the efficiency of health service delivery 12,13. Second, some previous evaluations at the national level were unable to distinguish the effects of each of these two policies from each other 5,10,11.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of HIV/AIDS Health Centers and Effect of Community-Based Health Insurance and Performance-Based Financing on HIV/AIDS Service Delivery in Rwanda

Zeng¹,

Rwiyereka²,

Amico³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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This study evaluates the efficiency of rural health centers in Rwanda in delivering the three key human immunodeficiency virus/acquired immunodeficiency syndrome services: antiretroviral treatment, prevention of mother-to-child transmission, and voluntary counseling and testing using data envelopment analysis, and assesses the impact of community-based health insurance (CBHI) and performance-based financing on improving the delivery of the three services. Results show that health centers average efficiency of 78%, and despite the observed variation, the performance increased by 15.6% from 2006 through 2007. When the services are examined separately, each 1% growth of CBHI use was associated with 3.7% more prevention of mother-to-child transmission and 2.5% more voluntary counseling and testing services. Although more health centers would have been needed to evaluate performance-based financing, we found that high use of CBHI in Rwanda was an important contributor to improving human immunodeficiency virus/acquired immunodeficiency syndrome services in rural health centers in Rwanda.

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Section: Introductionmentioning

confidence: 99%

Efficiency of HIV/AIDS Health Centers and Effect of Community-Based Health Insurance and Performance-Based Financing on HIV/AIDS Service Delivery in Rwanda

Zeng¹,

Rwiyereka²,

Amico³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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“…Resource needs projections for HIV treatment have been conducted at global [1,4] and country level [5,6], yet these efforts are hampered by a lack of data. Some data on service delivery costs have recently become available [7–12].…”

Section: Introductionmentioning

confidence: 99%

The cost of providing comprehensive HIV treatment in PEPFAR-supported programs

Menzies

Berruti

Berzon

et al. 2011

Aids

110

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PEPFAR, national governments, and other stakeholders are investing unprecedented resources to provide HIV treatment in developing countries. This study reports empirical data on costs and cost trends in a large sample of HIV treatment sites. In 2006–2007, we conducted cost analyses at 43 PEPFAR-supported outpatient clinics providing free comprehensive HIV treatment in Botswana, Ethiopia, Nigeria, Uganda, and Vietnam. We collected data on HIV treatment costs over consecutive 6-month periods from scale-up of dedicated HIV treatment services at each site. The study included all patients receiving HIV treatment and care at study sites (62,512 ART and 44,394 pre-ART patients). Outcomes were costs per-patient and total program costs, subdivided by major cost categories. Median annual economic costs were $202 (2009 USD) for pre-ART patients and $880 for ART patients. Excluding ARVs, per-patient ART costs were $298. Care for newly initiated ART patients cost 15–20% more than for established patients. Per-patient costs dropped rapidly as sites matured, with per-patient ART costs dropping 46.8% between first and second 6-month periods after the beginning of scale-up, and an additional 29.5% the following year. PEPFAR provided 79.4% of funding for service delivery, and national governments provided 15.2%. Treatment costs vary widely between sites, and high early costs drop rapidly as sites mature. Treatment costs vary between countries and respond to changes in ARV regimen costs and the package of services. While cost reductions may allow near-term program growth, programs need to weigh the trade-off between improving services for current patients and expanding coverage to new patients.

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“…Studies on costs of HIV treatment are usually performed through gross-costing techniques [6][7][8][9][10][11] , analyzing specific healthcare expenditures [12][13][14][15][16][17][18][19] , using private perspective [20][21][22][23][24] or exclusively using the costs for ARV provision [25][26][27][28][29] ; all of which report general trends of HIV treatment costs.…”

Section: Introductionmentioning

confidence: 99%

“…Although there is a general consensus on the considerable share of costs due to ARVs [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]30 , there is still lack of evidence on the major cost drivers of HIV outpatient treatment for individuals in different categories of CD4 cell count, particularly regarding nationwide publiclyfinanced HIV treatment programs, such as that of Brazil.…”

Section: Introductionmentioning

confidence: 99%