Ferroussier O, Kumar M K A, Dewan P K, Nair P K J, Sahu S, Wares D F, Laserson K, Wells C, Granich R, Chauhan L S
International Research and Programs Branch, Division of Tuberculosis Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Int J Tuberc Lung Dis. 2007 Jul;11(7):755-61.
Little is known yet about the cost-effectiveness of public-private mix (PPM) collaborations for the delivery of tuberculosis (TB) diagnostic and treatment services.
We evaluated the cost and cost-effectiveness of a PPM project targeting private laboratories in Kannur district, India, from the perspective of the Revised National TB Control Programme (RNTCP). We estimated the cost per provider recruited and retained, the cost per additional patient notified under various effectiveness scenarios and the cost per additional patient successfully treated. Intervention cost data were abstracted from RNTCP records. Treatment costs were estimated based on RNTCP case management protocols.
The annual total estimated cost of the project was US$8712-$11611. The cost per private provider recruited varied between US$22 and US$54. The cost per additional pulmonary TB patient privately diagnosed was US$14-$18. In the most conservative scenario, the cost per additional patient notified was US$29-$36. The cost per new acid-fast bacilli-positive patient successfully treated was US$47-$51. Higher notification rates would improve cost-effectiveness.
Comparisons with public sector diagnostic costs are required to determine if this intervention remains economically attractive to the public health care system at different activity levels and to determine the supplemental resources needed if scale-up is pursued.
关于公私合作（PPM）在结核病（TB）诊断和治疗服务提供方面的成本效益，目前了解甚少。
我们从修订后的国家结核病控制规划（RNTCP）的角度，评估了印度坎努尔区针对私立实验室的一个PPM项目的成本和成本效益。我们估算了招募和留住每位提供者的成本、在各种效果情景下每新增一例报告患者的成本以及每新增一例成功治疗患者的成本。干预成本数据取自RNTCP记录。治疗成本根据RNTCP病例管理方案估算。
该项目年度总估算成本为8712美元至11611美元。招募每位私立提供者的成本在22美元至54美元之间。每新增一例私立诊断的肺结核患者的成本为14美元至18美元。在最保守的情景下，每新增一例报告患者的成本为29美元至36美元。每新增一例成功治疗的耐酸杆菌阳性新患者的成本为47美元至51美元。更高的报告率将提高成本效益。
需要与公共部门诊断成本进行比较，以确定该干预措施在不同活动水平下对公共卫生保健系统是否仍具有经济吸引力，并确定如果扩大规模所需的补充资源。
