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Costing of Essential Health Service Packages: A Systematic Review of Methods From Developing Economies
Although an increasing number of countries are adopting essential health service packages (EHSPs) and undertaking their cost assessment, standardization of the costing methods and their reporting are imperative to instill confidence in the use of findings of EHSPs as evidence for decision making and...
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Published in: | Value in health 2021-11, Vol.24 (11), p.1700-1713 |
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Main Authors: | , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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Summary: | Although an increasing number of countries are adopting essential health service packages (EHSPs) and undertaking their cost assessment, standardization of the costing methods and their reporting are imperative to instill confidence in the use of findings of EHSPs as evidence for decision making and resource allocation. This review was conducted to synthesize the EHSP costing reports, focusing on the key costing methods and their reporting standards.
A systematic review of English language literature (peer-reviewed as well as gray) was conducted. PubMed, Embase, Scopus, NHS Economic Evaluation Database, Google Scholar, and websites of key institutions were reviewed (2000-2020). Publication characteristics, costing methods, valuation sources, quality, transparency, and reporting standards were assessed and synthesized.
A total of 29 studies from 19 countries were included. Most studies were government reports (69%) and reported the use of “bottom-up” approach (76%), OneHealth tool (38%), had international funding (79%), and reported both normative and empirical cost estimates (41%). Six studies (21%) scored “excellent” in conduct and reporting. Stand-alone costing of EHSP had higher mean quality score (80). The projected increase in government budget to implement EHSP ranged from 17% to 117%. Limited availability of reliable data on resources, prices, and coverage of interventions were identified as major limitations for costing of EHSPs.
Substantial differences in the costing methods and reporting standards of EHSPs made comparisons across countries difficult. Existing costing guidelines and checklists should be adapted for EHSPs with more specific methodological guidance to allow harmonization of methods and reporting.
•Costing of essential health service packages (EHSPs) generates evidence to inform policy makers for advocating for greater resources for health and defining scale-up path given the affordability.•There is a large variation in cost estimates of studies from different settings because of limitations of data availability, reliability, generalizability, and variations in methods and reporting formats.•There is a need for further comparison and evaluation of feasibility, appropriateness, bias, and other characteristics of costs estimates used in EHSPs, and over time, the development of consensus statement on how EHSP costing should be conducted and reported in different contexts. |
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ISSN: | 1098-3015 1524-4733 |
DOI: | 10.1016/j.jval.2021.05.021 |