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Disease Control Priorities Network (DCPN)
Principal Investigators:The Disease Control Priorities Network (DCPN) project aims to improve how health resources are allocated amongst interventions, service delivery platforms, and research and development of new health technologies. By producing estimates for the costs and effectiveness of health service delivery platforms and interventions in low- and middle-income countries, the DCPN team hopes to improve the health of people in developing countries by fostering an environment that supports evidence-based decision-making in global health. This project is supported by a grant from the Bill & Melinda Gates Foundation and will involve a number of collaborating institutions. Areas of InvestigationCosting: Assess costs and determinants of costs for health interventions and delivery platforms in the 21 Global Burden of Disease (GBD) regionsWhile there is an increasing body of literature on the costs of health care, researchers’ ability to accurately determine the costs of health service delivery is severely limited, particularly in low-and-middle-income settings. The Costing work group will focus on the collection of aggregate-level data for each production unit (e.g. hospitals, community health clinics, public health services) that is more readily available (e.g. total costs/ budgets, outpatient visits, capacity utilization). Econometric models will then be used to explain how the total cost of the production unit changes in response to differences in the number of intermediate outputs delivered (e.g. service mix, number of personnel, and scale of operations), which will help determine the setting-specific marginal cost of increasing intermediate outputs for each of the production units. In conjunction with each of the project’s expert groups, IHME will determine the quantities of the intermediate outputs required to deliver specific interventions in order to calculate the total cost of delivering each intervention. A large empirical database on production unit costs will also be used in the work on platforms to test the relationship between total costs and the production of intermediate products and other attributes of institutions, such as the availability of information and use of incentives. Interventions: Assess the cost-effectiveness of health interventions in the 21 GBD regionsResearchers will produce cost-effectiveness analysis (CEA) estimates for approximately 300 interventions tailored to the cost and epidemiology profile of the 21 GBD regions. This information will then be embedded in an updateable database on an on-going basis, which will have direct policy relevance. This effort will involve assessing determinants of the mutually influencing trajectories of health, nutritional, and cognitive development and will involve bringing in information on interventions outside the health sector such as water, sanitation, and particularly education. Platforms: Define and assess cost-effectiveness of relevant platforms to deliver selected interventions in the 21 GBD regions and review related policy leversMost cost-effectiveness analyses assess interventions but, arguably, most resource allocation is to the platforms that deliver interventions, such as hospitals or community health clinics. These platforms provide the point of intersection between health systems and the specific tasks that health systems must undertake. DCPN will develop the platform concept, assess avertable burden by platform, and provide solid empirical evidence on platform costs and cost effectiveness. In addition, given that governments can also shape the content, deployment, and quality of platforms through a number of policy levers, DCPN will assemble and present evidence on the effectiveness of different policy levers, including the amount and nature of human resource investments. Disease Control Priorities HistoryThe DCPN work stems from earlier research carried out in the late 1990's by the World Bank. In 1993, the Oxford University Press published the first edition of Disease Control Priorities in Developing Countries (DCP1) with contributions from the World Health Organization, world scholars, practitioners, and public health specialists. Then in April 2006, a second edition of Disease Control Priorities in Developing Countries (DCP2) was published, including updated information about the global burden of diseases brought about by tobacco, alcohol, psychiatric disorders, and injury. DCP2 highlights cost-effective interventions based on careful analysis of health systems, the costs of disease burden, treatment, and prevention for a comprehensive range of diseases and conditions. The impact of these publications was to stimulate national and international debate on health-sector investments, and to catalyze intensive work on the estimation of the disease burden and the cost-effectiveness of specific health interventions. Both publications have become reference works used extensively by policymakers, international development agencies, and academic institutions. Copies of the publications, original tables, and further information from the earlier work are available at http://www.dcp2.org/page/main/Home.html For more information, please contact: dcpn@healthmetricsandevaluation.org |
