Cost-effectiveness of health care service delivery interventions in low and middle income countries: a systematic review.

摘要: Low and middle income countries (LMICs) face severe resource limitations but the highest burden of disease. There is a growing evidence base on effective cost-effective interventions for these diseases. However, questions remain about most method delivery interventions. We aimed to review scope, quality, findings economic evaluations service in LMICs. searched PUBMED, MEDLINE, EconLit, NHS EED studies published between 1st January 2000 30th October 2016 with no language restrictions. included all that reported incremental costs benefits or summary measures two such as an cost effectiveness ratio. Studies were grouped by both disease area outcome measure permutation plots completed similar Quality was judged Drummond checklist. Overall, 3818 potentially relevant abstracts identified which 101 selected full text review. Thirty-seven final Twenty-three we classed “changing whom where care provided”, specifically entailed task-shifting from doctors nurses community health workers facilities into community. Evidence suggests this type intervention likely be cost-saving. Nine quality improvement initiatives, generally found cost-effective. methods differed widely limiting comparability findings. significant heterogeneity literature, methodologically quality. This renders further comparisons difficult limits utility available decision makers.