Chee Grace
Abt Associates Inc., 4800 Montgomery Lane, Suite 600, Bethesda, MD 20814, USA.
Int J Health Plann Manage. 2003 Jul-Sep;18(3):205-20. doi: 10.1002/hpm.710.
Despite much discussion of the role of private health care providers, there are no tried and tested models for supporting for-profit providers in ways that produce cost-effective public health outcomes. This paper examines the cost effectiveness of using a loan mechanism to motivate a for-profit provider to deliver family planning services. The intervention examined directly resulted in a private provider delivering family planning services, however, it did not create a long-term financial incentive for the private provider to promote the use of family planning. The cost effectiveness of this intervention is analysed using a methodology that captures long term sustainability of the intervention within a traditional family planning outcome measure, such as couple years protection (CYP), by discounting future expected CYPs. Depending on the method for analysing costs and assumptions regarding future CYPs, this intervention produced family planning outcomes at no or very low cost (0 dollars-4.11 dollars per CYP). The analysis demonstrates that innovative family planning interventions with private providers should be considered as they can be more cost effective than traditional programmes.
尽管对私营医疗服务提供者的作用进行了大量讨论，但目前尚无经过实践检验的模式来支持营利性提供者，以实现具有成本效益的公共卫生成果。本文研究了使用贷款机制激励营利性提供者提供计划生育服务的成本效益。所研究的干预措施直接促使一家私营提供者提供计划生育服务，然而，它并未为该私营提供者创造促进计划生育使用的长期财务激励。使用一种方法对该干预措施的成本效益进行分析，该方法通过对未来预期的夫妇年保护（CYP）进行贴现，在传统的计划生育成果指标（如夫妇年保护）内捕捉干预措施的长期可持续性。根据分析成本的方法以及关于未来CYP的假设，该干预措施以零成本或极低的成本（每CYP 0美元至4.11美元）产生了计划生育成果。分析表明，应考虑与私营提供者开展创新性计划生育干预措施，因为它们可能比传统项目更具成本效益。
