College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia.
Department of Monitoring, Evaluation and Research, African Medical and Research Foundation (AMREF), Addis Ababa, Ethiopia.
Cost Eff Resour Alloc. 2010 Jun 11;8(1):13. doi: 10.1186/1478-7547-8-13.
In countries with scarce specialized Human resource for health, patients are usually referred. The other alternative has been mobilizing specialists, clinical specialist outreach. This study examines whether clinical specialist outreach is a cost effective way of using scarce health expertise to provide specialist care as compared to provision of such services through referral system in Ethiopia.
A cross-sectional study on four purposively selected regional hospitals and three central referral hospitals was conducted from Feb 4-24, 2009. The perspective of analysis was societal covering analytic horizon and time frame from 1 April 2007 to 31 Dec 2008. Data were collected using interview of specialists, project focal persons, patients and review of records. To ensure the propriety standards of evaluation, Ethical clearance was obtained from Jimma University.
It was found that 532 patients were operated at outreach hospitals in 125 specialist days. The unit cost of surgical procedures was found to be ETB 4,499.43. On the other hand, if the 125 clinical specialist days were spent to serve patients referred from zonal and regional hospitals at central referral hospitals, 438 patients could have been served. And the unit cost of surgical procedures through referral would have been ETB 6,523.27 per patient. This makes clinical specialist outreach 1.45 times more cost effective way of using scarce clinical specialists' time as compared to referral system.
Clinical specialist outreach is a cost effective and cost saving way of spending clinical specialists' time as compared to provision of similar services through referral system.
在人力资源匮乏的国家，患者通常会被转诊。另一种选择是动员专家，开展临床专家外展服务。本研究旨在探讨在埃塞俄比亚，与通过转诊系统提供此类服务相比，临床专家外展是否是一种利用稀缺卫生专业知识提供专科护理的具有成本效益的方法。
本研究于 2009 年 2 月 4 日至 24 日在四个有目的地选择的地区医院和三个中央转诊医院进行了一项横断面研究。分析视角涵盖了社会层面，分析时间范围为 2007 年 4 月 1 日至 2008 年 12 月 31 日。数据通过对专家、项目负责人、患者进行访谈以及查阅记录收集。为确保评估的适当标准，从 Jimma 大学获得了伦理批准。
研究发现，在 125 个专科日期间，有 532 名患者在外出医院接受了手术。手术程序的单位成本被发现为 4499.43 比尔。另一方面，如果将 125 个临床专家日用于服务中央转诊医院转诊的区和地区医院的患者，那么可服务的患者人数为 438 人。而通过转诊提供手术服务的单位成本将为每位患者 6523.27 比尔。这使得与转诊系统相比，临床专家外展是一种更具成本效益的利用稀缺临床专家时间的方式，其效率提高了 1.45 倍。
与通过转诊系统提供类似服务相比，临床专家外展是一种利用临床专家时间的具有成本效益和节省成本的方法。
