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LIBRIS Formathandbok  (Information om MARC21)
00004745naa a22005893a 4500
008171206s2014 sw |||| o |||| ||eng c
024a http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-905752 uri
024a urn:nbn:se:umu:diva-905752 urn
024a 10.3402/gha.v7.232572 doi
040 a S
041a eng
042 9 EPLK
100a Batura, Neha4 aut
2451 0a Collecting and analysing cost data for complex public health trialsh [Elektronisk resurs]b reflections on practice
260 b CoAction Publishingc 2014
500 a Published
506a gratis
520 a BACKGROUND: Current guidelines for the conduct of cost-effectiveness analysis (CEA) are mainly applicable to facility-based interventions in high-income settings. Differences in the unit of analysis and the high cost of data collection can make these guidelines challenging to follow within public health trials in low- and middle- income settings. OBJECTIVE: This paper reflects on the challenges experienced within our own work and proposes solutions that may be useful to others attempting to collect, analyse, and compare cost data between public health research sites in low- and middle- income countries. DESIGN: We describe the generally accepted methods (norms) for collecting and analysing cost data in a single-site trial from the provider perspective. We then describe our own experience applying these methods within eight comparable cluster randomised, controlled, trials. We describe the strategies used to maximise adherence to the norm, highlight ways in which we deviated from the norm, and reflect on the learning and limitations that resulted. RESULTS: When the expenses incurred by a number of small research sites are used to estimate the cost-effectiveness of delivering an intervention on a national scale, then deciding which expenses constitute 'start-up' costs will be a nontrivial decision that may differ among sites. Similarly, the decision to include or exclude research or monitoring and evaluation costs can have a significant impact on the findings. We separated out research costs and argued that monitoring and evaluation costs should be reported as part of the total trial cost. The human resource constraints that we experienced are also likely to be common to other trials. As we did not have an economist in each site, we collaborated with key personnel at each site who were trained to use a standardised cost collection tool. This approach both accommodated our resource constraints and served as a knowledge sharing and capacity building process within the research teams. CONCLUSIONS: Given the practical reality of conducting randomised, controlled trials of public health interventions in low- and middle- income countries, it is not always possible to adhere to prescribed guidelines for the analysis of cost effectiveness. Compromises are frequently required as researchers seek a pragmatic balance between rigor and feasibility. There is no single solution to this tension but researchers are encouraged to be mindful of the limitations that accompany compromise, whilst being reassured that meaningful analyses can still be conducted with the resulting data.
650 7a Medical and Health Sciences2 hsv
650 7a Health Sciences2 hsv
650 7a Public Health, Global Health, Social Medicine and Epidemiology2 hsv
650 7a Medicin och hälsovetenskap2 hsv
650 7a Hälsovetenskaper2 hsv
650 7a Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi2 hsv
653 0a cost-effectiveness analysis
653 0a cost data
653 0a LMIC; multisite
653 0a randomised control trials
700a Pulkki-Brännström, Anni-Maria4 aut
700a Agrawal, Priya4 aut
700a Bagra, Archana4 aut
700a Haghparast-Bidgoli, Hassan4 aut
700a Bozzani, Fiammetta4 aut
700a Colbourn, Tim4 aut
700a Greco, Giulia4 aut
700a Hossain, Tanvir4 aut
700a Sinha, Rajesh4 aut
700a Thapa, Bidur4 aut
700a Skordis-Worrall, Jolene4 aut
7721 8i channel recordw 18813935
7730 8i Värdpublikationt Global Health Actiong 7, 23257x 1654-9716
8564 0u http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-90575
8564 0u http://dx.doi.org/10.3402/gha.v7.23257
8564 0u http://umu.diva-portal.org/smash/get/diva2:728597/FULLTEXT01
841 5 APISa x ab 171206||0000|||||001||||||000000e 1
0245 APISa urn:nbn:se:umu:diva-905752 urn
852 5 APISb APIS
8564 05 APISu http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-90575

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