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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Williamson, Anne de León, Lorena Ponce Garza, Francisco Rodríguez Macías, Valeria Flores Navarro, Hugo |
| Abstract | Background In rural settings where patients face significant structural barriers to accessing healthcare services, the formal existence of government-provided health coverage does not necessarily translate to meaningful care delivery. This paper analyses the effectiveness of an innovative approach to overcome these barriers, the Right to Health Care programme offered by Compañeros en Salud in Chiapas, Mexico. This programme provides comprehensive free coverage of all additional direct and indirect medical costs as well as accompaniment through the medical system. Over 550 patients had participated from 2013 until November 2018. Methods Focusing on ten of the most frequently treated conditions, including hernias, cataracts and congenital heart defects, we performed a retrospective case study analysis of the quality-adjusted life years (QALYs) gained from treatment and the cost per QALY for 69 patients. This analysis used disability weights and uncertainty intervals from the Global Burden of Disease study and organisational micro-costing data for each patient. Each patient was compared to their own hypothetical counterfactual health outcome had they not received the secondary and tertiary care required for the specific condition. A mixed methods approach is used to establish this counterfactual baseline, drawing on pre-intervention observations, qualitative interviews and established literature precedent. Results The programme was found to deliver an average of 14.4 additional QALYs (95% uncertainty interval 12.4–15.8) without time discounting. The mean cost per QALY over these conditions was $388 USD (95% UI $262–588) at purchasing power parity. Conclusions These numbers compare favourably with studies of other health services and international cost per QALY guidelines. They reflect the on-treatment effect for the ten conditions analysed and are presented as a case study indicative of the promise of healthcare intermediaries rather than a definitive assessment of cost-effectiveness. Nonetheless, these results show the potential feasibility and cost effectiveness of a more comprehensive approach to healthcare provision in a resource-limited rural setting. Trial registration This study involves economic analysis of a programme facilitating access to public healthcare services. Thus, there was no associated clinical trial to be registered. |
| Related Links | https://health-policy-systems.biomedcentral.com/counter/pdf/10.1186/s12961-020-00563-3.pdf |
| Ending Page | 14 |
| Page Count | 14 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14784505 |
| DOI | 10.1186/s12961-020-00563-3 |
| Journal | Health Research Policy and Systems |
| Issue Number | 1 |
| Volume Number | 18 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2020-05-22 |
| Access Restriction | Open |
| Subject Keyword | Health Administration R & D Technology Policy Medicine Public Health Health Services Research Health Policy Health systems quality adjusted life years cost-effectiveness analysis health economics rural health Mexico R & D/Technology Policy Medicine/Public Health |
| Content Type | Text |
| Resource Type | Article |
| Subject | Health Policy |
| Journal Impact Factor | 3.6/2023 |
| 5-Year Journal Impact Factor | 4.3/2023 |
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