Experience in implementing results-based financing in the practice of providing services to patients with tuberculosis
Journal Title: Туберкульоз, легеневі хвороби, ВІЛ-інфекція - Year 2018, Vol 0, Issue 1
Abstract
Objective — to describe implementation process of the pilot project «Result based funding for DOT provision for TB patients at ambulatory treatment phase» (hereinafter — Project) in Odessa region and assess its effectiveness. Materials and methods. The study describes the analysis of 422 patients with drugsusceptible TB and 60 patients with XDR TB, who received DOT at ambulatory treatment phase within the Project in Odesa region in 2017. The results of treatment of patients with susceptible TB in the first and second cohort of 2017 (140 people) that completed the course were taken into account to assess the effectiveness of the model. Results and discussion. ICF «Alliance for public health» with the financial support of the Global Fund to Fight AIDS, Tuberculosis and Malaria has implemented pilot project «Result based funding for DOT provision for TB patients at ambulatory treatment phase» throughout involvement of specialists from primary health centers (hereinafter — PHC). The purpose of the project is to pilot new for Ukraine model of financing DOT for patients with TB at ambulatory treatment phase in order to focus medical staff of PHC on results: reduce the number of treatment interruptions to zero and improve treatment effectiveness. Conclusions. The project provided DOT at ambulatory treatment phase for 422 patients with TB and 60 patients with MDR TB through the involvement of specialists from the PHCs. The average cost of a DOT at ambulatory treatment phase for 6month course of TB patient treatment on the basis of PHC within the Project amounted to 2288 UAH for TB and 2.652 UAH for XDRTB. Resultsbased financing is an inconsiderable, but effective method of encouraging PHC specialists to provide services to TB/XDRTB patients. Mentioned financing model for medical establishments allows the transition to outpatient patientoriented TB/XDRTB treatment models with the achievement of effective treatment outcomes. The project demonstrated the ability to provide high efficacy in the treatment of TB patients (92.9 %). Piloted RBF model on service provision for TB patients at the basis of PHC can provide essential grounds for comprehensive strategy on ensuring sustainability of TB programs that will contribute to achieving the goals of the WHO TB Ends Strategy.
Authors and Affiliations
Е. P. Geliukh, N. M. Kamenskaya, O. I. Masіuk, S. A. Filippovich
Keywords
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