Applying the net-benefit framework for assessing cost-effectiveness of interventions towards universal health coverage

被引：11
作者：
Hounton S. [1 ]
Newlands D. [2 ]
机构：
[1] Department of Epidemiology, Centre MURAZ, 2054 Avenue Mamadou KONATE, Bobo-Dioulasso
[2] Business School, University of Aberdeen, Edward Wright Building, Dunbar Street, Old Aberdeen, AB24 3QY, Scotland
来源：
Cost Effectiveness and Resource Allocation | / 10卷 / 1期
关键词：
Cost-effectiveness analysis; Net-benefit framework; Universal health coverage;
D O I：
10.1186/1478-7547-10-8
中图分类号：
学科分类号：
摘要：
In assessing the cost-effectiveness of an intervention, the interpretation and handling of uncertainties of the traditional summary measure, the Incremental Cost Effectiveness Ratio (ICER), can be problematic. This is particularly the case with strategies towards universal health coverage in which the decision makers are typically concerned with coverage and equity issues. We explored the feasibility and relative advantages of the net-benefit framework (NBF) (compared to the more traditional Incremental Cost-Effectiveness Ratio, ICER) in presenting results of cost-effectiveness analysis of a community based health insurance (CBHI) scheme in Nouna, a rural district of Burkina Faso. Data were collected from April to December 2007 from Nouna's longitudinal Demographic Surveillance System on utilization of health services, membership of the CBHI, covariates, and CBHI costs. The incremental cost of a 1 increase in utilization of health services by household members of the CBHI was 433,000 XOF ($1000 approximately). The incremental cost varies significantly by covariates. The probability of the CBHI achieving a 1% increase in utilization of health services, when the ceiling ratio is $1,000, is barely 30% for households in Nouna villages compared to 90% for households in Nouna town. Compared to the ICER, the NBF provides more useful information for policy making. © 2012 Hounton and Newlands; licensee BioMed Central Ltd.
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