Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa

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dc.contributor.authorSinanovic, Edinaen_ZA
dc.contributor.authorKumaranayake, Lilanien_ZA
dc.date.accessioned2015-11-11T11:55:20Z
dc.date.available2015-11-11T11:55:20Z
dc.date.issued2006en_ZA
dc.description.abstractBACKGROUND: Public-private partnerships (PPP) could be effective in scaling up services. We estimated cost and cost-effectiveness of different PPP arrangements in the provision of tuberculosis (TB) treatment, and the financing required for the different models from the perspective of the provincial TB programme, provider, and the patient. METHODS: Two different models of TB provider partnerships are evaluated, relative to sole public provision: public-private workplace (PWP) and public-private non-government (PNP). Cost and effectiveness data were collected at six sites providing directly observed treatment (DOT). Effectiveness for a 12-month cohort of new sputum positive patients was measured using cure and treatment success rates. Provider and patient costs were estimated, and analysed according to sources of financing. Cost-effectiveness is estimated from the perspective of the provider, patient and society in terms of the cost per TB case cured and cost per case successfully treated. RESULTS: Cost per case cured was significantly lower in PNP (US $354-446), and comparable between PWP (US $788-979) and public sites (US $700-1000). PPP models could significantly reduce costs to the patient by 64-100%. Relative to pure public sector provision and financing, expansion of PPPs could reduce government financing required per TB patient treated from $609-690 to $130-139 in PNP and $36-46 in PWP. CONCLUSION: There is a strong economic case for expanding PPP in TB treatment and potentially for other types of health services. Where PPPs are tailored to target groups and supported by the public sector, scaling up of effective services could occur at much lower cost than solely relying on public sector models.en_ZA
dc.identifier.apacitationSinanovic, E., & Kumaranayake, L. (2006). Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa. <i>Cost Effectiveness and Resource Allocation</i>, http://hdl.handle.net/11427/14863en_ZA
dc.identifier.chicagocitationSinanovic, Edina, and Lilani Kumaranayake "Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa." <i>Cost Effectiveness and Resource Allocation</i> (2006) http://hdl.handle.net/11427/14863en_ZA
dc.identifier.citationSinanovic, E., & Kumaranayake, L. (2006). Cost Effectiveness and Resource Allocation. Cost Effectiveness and Resource Allocation, 4, 11.en_ZA
dc.identifier.ris TY - Journal Article AU - Sinanovic, Edina AU - Kumaranayake, Lilani AB - BACKGROUND: Public-private partnerships (PPP) could be effective in scaling up services. We estimated cost and cost-effectiveness of different PPP arrangements in the provision of tuberculosis (TB) treatment, and the financing required for the different models from the perspective of the provincial TB programme, provider, and the patient. METHODS: Two different models of TB provider partnerships are evaluated, relative to sole public provision: public-private workplace (PWP) and public-private non-government (PNP). Cost and effectiveness data were collected at six sites providing directly observed treatment (DOT). Effectiveness for a 12-month cohort of new sputum positive patients was measured using cure and treatment success rates. Provider and patient costs were estimated, and analysed according to sources of financing. Cost-effectiveness is estimated from the perspective of the provider, patient and society in terms of the cost per TB case cured and cost per case successfully treated. RESULTS: Cost per case cured was significantly lower in PNP (US $354-446), and comparable between PWP (US $788-979) and public sites (US $700-1000). PPP models could significantly reduce costs to the patient by 64-100%. Relative to pure public sector provision and financing, expansion of PPPs could reduce government financing required per TB patient treated from $609-690 to $130-139 in PNP and $36-46 in PWP. CONCLUSION: There is a strong economic case for expanding PPP in TB treatment and potentially for other types of health services. Where PPPs are tailored to target groups and supported by the public sector, scaling up of effective services could occur at much lower cost than solely relying on public sector models. DA - 2006 DB - OpenUCT DO - 10.1186/1478-7547-4-11 DP - University of Cape Town J1 - Cost Effectiveness and Resource Allocation LK - https://open.uct.ac.za PB - University of Cape Town PY - 2006 T1 - Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa TI - Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa UR - http://hdl.handle.net/11427/14863 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14863
dc.identifier.urihttp://dx.doi.org/10.1186/1478-7547-4-11
dc.identifier.vancouvercitationSinanovic E, Kumaranayake L. Financing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africa. Cost Effectiveness and Resource Allocation. 2006; http://hdl.handle.net/11427/14863.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2006 Sinanovic and Kumaranayake; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceCost Effectiveness and Resource Allocationen_ZA
dc.source.urihttp://www.resource-allocation.com/en_ZA
dc.subject.otherCost-effectiveness analysisen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherDirectly observed treatmenten_ZA
dc.subject.otherHealth Economicsen_ZA
dc.titleFinancing and cost-effectiveness analysis of public-private partnerships: provision of tuberculosis treatment in South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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