Avenir Health, Glastonbury, P.O. Box 1337, CT, 06033-6337, Glastonbury, USA.
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, MA, Boston, USA.
BMC Public Health. 2023 Jun 2;23(1):1055. doi: 10.1186/s12889-023-15964-6.
Most low- and middle-income countries have limited access to cost data that meets the needs of health policy-makers and researchers in health intervention areas including HIV, tuberculosis, and immunization. Unit cost repositories (UCRs)-searchable databases that systematically codify evidence from costing studies-have been developed to reduce the effort required to access and use existing costing information. These repositories serve as public resources and standard references, which can improve the consistency and quality of resource needs projections used for strategic planning and resource mobilization. UCRs also enable analysis of cost determinants and more informed imputation of missing cost data. This report examines our experiences developing and using seven UCRs (two global, five country-level) for cost projection and research purposes.
We identify advances, challenges, enablers, and lessons learned that might inform future work related to UCRs. Our lessons learned include: (1) UCRs do not replace the need for costing expertise; (2) tradeoffs are required between the degree of data complexity and the useability of the UCR; (3) streamlining data extraction makes populating the UCR with new data easier; (4) immediate reporting and planning needs often drive stakeholder interest in cost data; (5) developing and maintaining UCRs requires dedicated staff time; (6) matching decision-maker needs with appropriate cost data can be challenging; (7) UCRs must have data quality control systems; (8) data in UCRs can become obsolete; and (9) there is often a time lag between the identification of a cost and its inclusion in UCRs.
UCRs have the potential to be a valuable public good if kept up-to-date with active quality control and adequate support available to end-users. Global UCR collaboration networks and greater control by local stakeholders over global UCRs may increase active, sustained use of global repositories and yield higher quality results for strategic planning and resource mobilization.
大多数中低收入国家获取成本数据的渠道有限，而这些数据是卫生政策制定者和研究人员在艾滋病毒、结核病和免疫等卫生干预领域开展工作所必需的。单位成本存储库（UCR）是一种可搜索的数据库，它对成本研究中的证据进行了系统的编码，可以减少获取和使用现有成本信息所需的工作量。这些存储库是公共资源和标准参考，可以提高战略规划和资源调动中资源需求预测的一致性和质量。UCR 还可以分析成本决定因素，并更准确地推断缺失的成本数据。本报告考察了我们为成本预测和研究目的开发和使用七个 UCR（两个全球、五个国家层面）的经验。
我们确定了在开发和使用 UCR 方面的进展、挑战、推动因素和经验教训，这些经验教训可能为未来与 UCR 相关的工作提供信息。我们的经验教训包括：（1）UCR 并不能替代成本核算专业知识的需求；（2）需要在数据复杂性程度和 UCR 的可用性之间进行权衡；（3）简化数据提取使向 UCR 中添加新数据变得更容易；（4）决策者的即时报告和规划需求通常会推动利益相关者对成本数据的兴趣；（5）开发和维护 UCR 需要专门的员工时间；（6）使决策者的需求与适当的成本数据相匹配可能具有挑战性；（7）UCR 必须有数据质量控制系统；（8）UCR 中的数据可能会过时；（9）成本数据通常需要一定的时间才能被纳入 UCR。
如果 UCR 保持最新状态并为最终用户提供积极的质量控制和足够的支持，它们有可能成为有价值的公共产品。全球 UCR 协作网络以及当地利益相关者对全球 UCR 的更大控制，可能会增加对全球存储库的积极、持续使用，并为战略规划和资源调动提供更高质量的结果。
