Abstract：
BACKGROUND: The Federal Ministry of National Health Services, Regulations and Coordination (MNHSR&C) in Pakistan has committed to progress towards universal health coverage (UHC) by 2030 by providing an Essential Package of Health Services (EPHS). Starting in 2019, the Disease Control Priorities 3rd edition (DCP3) evidence framework was used to guide the development of Pakistan\'s EPHS. In this paper, we describe the methods and results of a rapid costing approach used to inform the EPHS design process.
METHODS: A total of 167 unit costs were calculated through a context-specific, normative, ingredients-based, and bottom-up economic costing approach. Costs were constructed by determining resource use from descriptions provided by MNHSR&C and validated by technical experts. Price data from publicly available sources were used. Deterministic univariate sensitivity analyses were carried out.
RESULTS: Unit costs ranged from 2019 US$ 0.27 to 2019 US$ 1478. Interventions in the cancer package of services had the highest average cost (2019 US$ 837) while interventions in the environmental package of services had the lowest (2019 US$ 0.68). Cost drivers varied by platform; the two largest drivers were drug regimens and surgery-related costs. Sensitivity analyses suggest our results are not sensitive to changes in staff salary but are sensitive to changes in medicine pricing.
CONCLUSIONS: We estimated a large number of context-specific unit costs, over a six-month period, demonstrating a rapid costing method suitable for EPHS design.
METHODS: A total of 167 unit costs were calculated through a context-specific, normative, ingredients-based, and bottom-up economic costing approach. Costs were constructed by determining resource use from descriptions provided by MNHSR&C and validated by technical experts. Price data from publicly available sources were used. Deterministic univariate sensitivity analyses were carried out.
RESULTS: Unit costs ranged from 2019 US$ 0.27 to 2019 US$ 1478. Interventions in the cancer package of services had the highest average cost (2019 US$ 837) while interventions in the environmental package of services had the lowest (2019 US$ 0.68). Cost drivers varied by platform; the two largest drivers were drug regimens and surgery-related costs. Sensitivity analyses suggest our results are not sensitive to changes in staff salary but are sensitive to changes in medicine pricing.
CONCLUSIONS: We estimated a large number of context-specific unit costs, over a six-month period, demonstrating a rapid costing method suitable for EPHS design.
摘要：
背景：联邦国家卫生服务部，巴基斯坦的法规与协调（MNHSR＆C）承诺通过提供基本的卫生服务包（EPHS），到2030年实现全民健康覆盖（UHC）。从2019年开始，疾病控制优先事项第3版（DCP3）证据框架被用来指导巴基斯坦EPHS的发展。在本文中,我们描述了用于为EPHS设计过程提供信息的快速成本计算方法的方法和结果。
方法：通过特定环境计算了总共167个单位成本，规范性，基于成分，和自下而上的经济成本计算方法。成本是通过根据MNHSR＆C提供的描述确定资源使用并由技术专家验证来构建的。使用公开来源的价格数据。进行了确定性单变量敏感性分析。
结果：单位成本从2019年的0.27美元到2019年的1478美元不等。癌症一揽子服务中的干预措施平均成本最高(2019年837美元)，而环境一揽子服务中的干预措施最低(2019年0.68美元)。成本驱动因素因平台而异；两个最大的驱动因素是药物治疗和手术相关成本。敏感性分析表明，我们的结果对员工工资的变化不敏感，但对药品价格的变化敏感。
结论：我们估计了大量特定环境的单位成本，在六个月的时间里，展示了一种适用于EPHS设计的快速成本计算方法。
方法：通过特定环境计算了总共167个单位成本，规范性，基于成分，和自下而上的经济成本计算方法。成本是通过根据MNHSR＆C提供的描述确定资源使用并由技术专家验证来构建的。使用公开来源的价格数据。进行了确定性单变量敏感性分析。
结果：单位成本从2019年的0.27美元到2019年的1478美元不等。癌症一揽子服务中的干预措施平均成本最高(2019年837美元)，而环境一揽子服务中的干预措施最低(2019年0.68美元)。成本驱动因素因平台而异；两个最大的驱动因素是药物治疗和手术相关成本。敏感性分析表明，我们的结果对员工工资的变化不敏感，但对药品价格的变化敏感。
结论：我们估计了大量特定环境的单位成本，在六个月的时间里，展示了一种适用于EPHS设计的快速成本计算方法。
