16 results found
Hauck K, Morton A, Chalkidou K, et al., 2018, How can we evaluate the cost-effectiveness of health system strengthening? A typology and illustrations., Soc Sci Med, Vol: 220, Pages: 141-149
Health interventions often depend on a complex system of human and capital infrastructure that is shared with other interventions, in the form of service delivery platforms, such as healthcare facilities, hospitals, or community services. Most forms of health system strengthening seek to improve the efficiency or effectiveness of such delivery platforms. This paper presents a typology of ways in which health system strengthening can improve the economic efficiency of health services. Three types of health system strengthening are identified and modelled: (1) investment in the efficiency of an existing shared platform that generates positive benefits across a range of existing interventions; (2) relaxing a capacity constraint of an existing shared platform that inhibits the optimization of existing interventions; (3) providing an entirely new shared platform that supports a number of existing or new interventions. Theoretical models are illustrated with examples, and illustrate the importance of considering the portfolio of interventions using a platform, and not just piecemeal individual analysis of those interventions. They show how it is possible to extend principles of conventional cost-effectiveness analysis to identify an optimal balance between investing in health system strengthening and expenditure on specific interventions. The models developed in this paper provide a conceptual framework for evaluating the cost-effectiveness of investments in strengthening healthcare systems and, more broadly, shed light on the role that platforms play in promoting the cost-effectiveness of different interventions.
Thomas R, Burger R, Hauck K, 2018, Richer, wiser and in better health? The socioeconomic gradient inhypertension prevalence, unawareness and control in South Africa., Social Science and Medicine, Vol: 217, Pages: 18-30, ISSN: 0277-9536
The socioeconomic gradient in chronic conditions is clear in the poorest and wealthiest of countries, but extant evidence on this relationship in low- and middle-income countries is inconclusive. We use data gathered between 2008-2012 from a nationally representative sample of over 10,000 South African adults, and objective health measures to analyse the differential effects of education, income and other factors on the prevalence of hypertension, individuals' awareness and control of hypertensive status. Prevalence of hypertension is high at 38% amongwomen and 34% among men. 59% of hypertensive individuals are unaware of their status. We and prevalence and unawareness of hypertension are a public health concern across all incomegroups in South Africa. Higher income is however associated with effective control amongst men. Completing secondary education is associated with 7 mmHg lower blood pressure only in a small sub-group of women but is associated with 22 percentage point higher likelihoodof effective hypertension control amongst women. We conclude that poorer and less educated individuals are particularly at high risk of cardiovascular disease in South Africa.
Morton A, Arulselvan A, Thomas R, 2018, Allocation rules for global donors, JOURNAL OF HEALTH ECONOMICS, Vol: 58, Pages: 67-75, ISSN: 0167-6296
Thomas R, Burger R, Harper A, et al., 2017, Differences in health-related quality of life between HIV-positive and HIV-negative people in Zambia and South Africa: a cross-sectional baseline survey of the HPTN 071 (PopART) trial, LANCET GLOBAL HEALTH, Vol: 5, Pages: E1133-E1141, ISSN: 2214-109X
Cundale K, Thomas R, Malaya JK, et al., 2017, A health intervention or a kitchen appliance? Household costs and benefits of a cleaner burning biomass-fuelled cookstove in Malawi, SOCIAL SCIENCE & MEDICINE, Vol: 183, Pages: 1-10, ISSN: 0277-9536
Hauck K, Thomas R, Smith PC, 2017, Beyond cost-effectiveness: Health systems constraints to delivery of a health benefits package, What's In, What's Out: Designing Benefits for Universal Health Coverage, Pages: 201-213, ISBN: 9781944691059
Thomas RA, Chalkidou K, 2016, Cost–effectiveness analysis, Health System Efficiency How to Make Measurement Matter for Policy and Management, Editors: Smith, Cylus, Papanicolas, Publisher: European Observatory on Health Systems and Policies, ISBN: 9789289050418
In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques.
Morton A, Thomas R, Smith PC, 2016, Decision rules for allocation of finances to health systems strengthening, JOURNAL OF HEALTH ECONOMICS, Vol: 49, Pages: 97-108, ISSN: 0167-6296
Heffernan A, Barber E, Thomas R, et al., 2016, Impact and Cost-Effectiveness of Point-Of-Care CD4 Testing on the HIV Epidemic in South Africa, PLOS ONE, Vol: 11, ISSN: 1932-6203
Fenton R, Nyamukapa C, Gregson S, et al., 2016, Wealth differentials in the impact of conditional and unconditional cash transfers on education: findings from a community-randomised controlled trial in Zimbabwe, PSYCHOLOGY HEALTH & MEDICINE, Vol: 21, Pages: 909-917, ISSN: 1354-8506
Hauck K, Thomas R, Smith PC, 2016, Departures from Cost-Effectiveness Recommendations: The Impact of Health System Constraints on Priority Setting, HEALTH SYSTEMS & REFORM, Vol: 2, Pages: 61-70, ISSN: 2328-8604
Thomas R, 2012, CONDITIONAL CASH TRANSFERS TO IMPROVE EDUCATION AND HEALTH: AN EX ANTE EVALUATION OF RED DE PROTECCION SOCIAL, NICARAGUA, Publisher: WILEY-BLACKWELL
Thomas R, 2012, CONDITIONAL CASH TRANSFERS TO IMPROVE EDUCATION AND HEALTH: AN EX ANTE EVALUATION OF RED DE PROTECCIÓN SOCIAL, NICARAGUA, Health Economics, Vol: 21, Pages: 1136-1154, ISSN: 1057-9230
Jones AM, Squire L, Thomas R, 2010, EVALUATING INNOVATIVE HEALTH PROGRAMS INTRODUCTION, HEALTH ECONOMICS, Vol: 19, Pages: 1-4, ISSN: 1057-9230
Thomas R, Jones A, Squire L, 2010, Methods for Evaluating Innovative Health Programs: a multi-country study, Journal of Development Effectiveness, Vol: 2, Pages: 504-520
Designed as a global research initiative, the Evaluating Innovative Health Programs project aims at adding to the evidence base of health interventions that have the potential to improve health outcomes in Africa and Asia. The project focuses on rigorous, quantitative evaluations of innovative local initiatives that address the Millennium Development Goals for health: reductions in child and maternal mortality and communicable diseases. This overview brings together the outcomes and lessons from the project for evaluation methods. It draws together the methodological implications of carrying out impact evaluations under very different settings and emphasises the need to build evaluations into project designs.
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