Kumar Dinesh, Prinja Shankar
Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, 176001, India.
School of Public Health and Community Medicine, Post Graduate Institute of Medical Education and Research. Chandigarh, 160012, India.
Indian J Tuberc. 2023 Apr;70(2):232-238. doi: 10.1016/j.ijtb.2022.05.009. Epub 2022 May 27.
Costing of resources helps to measure financial implications and effective utilization of resources of national programs. As there is limited evidence about cost per service, current study was done to assess the cost of services under National Tuberculosis Elimination Program (NTEP) at Community Health Centres (CHCs) and Primary Health Centres (PHCs) of northern state of India.
Cross-sectional study carried out in two districts and from each district eight CHCs and PHCs were randomly selected.
Mean annual cost of providing NTEP services at CHCs and PHCs were US$5243.1 (95%CI: 3008.0-7225.4) and US$1031.9 (95%CI: 669.1-1447.1) respectively. Across both centres human resource contributes to the most (CHC: 72.9%; PHC: 85.9%). One way sensitivity analysis was carried out for all health facilities and observed that human resource cost influences most cost per treated case by providing services under NTEP. Although relatively very less but cost of drugs also influences cost per treatment.
Cost of delivering services was high for CHCs as compared to PHCs. At both types of health facilities, human resource contributes the most to cost of delivering services under the program.
资源成本核算有助于衡量国家项目的财务影响和资源的有效利用。由于关于每项服务成本的证据有限，因此开展了本研究，以评估印度北部某邦社区卫生中心（CHC）和初级卫生中心（PHC）在国家结核病消除计划（NTEP）下的服务成本。
在两个地区开展横断面研究，从每个地区随机选取8个CHC和PHC。
CHC和PHC提供NTEP服务的年均成本分别为5243.1美元（95%CI：3008.0 - 7225.4）和1031.9美元（95%CI：669.1 - 1447.1）。在这两类中心中，人力资源成本占比最高（CHC：72.9%；PHC：85.9%）。对所有医疗机构进行了单因素敏感性分析，发现人力资源成本对NTEP下提供服务的每例治疗成本影响最大。虽然药品成本相对较低，但也会影响每次治疗的成本。
与PHC相比，CHC提供服务的成本较高。在这两类卫生机构中，人力资源在该项目下提供服务的成本中占比最大。
