Supporting the revision of the health benefits package in Uganda: A constrained optimisation approach. (15th March 2023)

• Record Type: Journal Article
• Authors: Mohan, Sakshi; Walker, Simon; Sengooba, Freddie; Kiracho, Elizabeth Ekirapa; Mayora, Chrispus; Ssennyonjo, Aloysius; Aliti, Candia Tom; Revill, Paul
• Is Part Of: Health economics. Volume 32:Number 6(2023)
• Page Start: 1244
• Page End: 1255
• Publication Date: 2023-03-15
• Subjects: constrained optimization -- cost‐effectiveness -- health benefits package -- linear programming -- resource allocation; Medical economics -- Periodicals; Economics, Medical -- Periodicals; Health Care Costs -- Periodicals; Health Policy -- economics -- Periodicals; Health Services -- economics -- Periodicals; 362.1
• DOI: 10.1002/hec.4664
• Languages: English
• ISSNs: 1057-9230

Abstract

Abstract: This study demonstrates how the linear constrained optimization approach can be used to design a health benefits package (HBP) which maximises the net disability adjusted life years (DALYs) averted given the health system constraints faced by a country, and how the approach can help assess the marginal value of relaxing health system constraints. In the analysis performed for Uganda, 45 interventions were included in the HBP in the base scenario, resulting in a total of 26.7 million net DALYs averted. When task shifting of pharmacists' and nutrition officers' tasks to nurses is allowed, 73 interventions were included in the HBP resulting in a total of 32 million net DALYs averted (a 20% increase). Further, investing only $58 towards hiring additional nutrition officers' time could avert one net DALY; this increased to $60 and $64 for pharmacists and nurses respectively, and $100, 000 for expanding the consumable budget, since human resources present the main constraint to the system.