Costing and Technical Efficiency
How can we know the amount of resources required for health, and ensure that they are well used?
The work on costing and technical efficiency explores questions around resource use in the health sector. Strategies for improving health and expanding access to health care services need to be examined from a resource perspective in order to ensure that they are feasible, efficient and affordable. Cost estimation may be needed at different levels, in order to answer different questions being asked:
- What is the cost of introducing a new health service, a health technology or a vaccine?
What is the budget required to implement a health sector strategy, and within that, what are the cost drivers (how should resources be apportioned)?
How much would we need to increase health spending if we wanted to reach a new set of ambitious health goals?
Quantities and unit prices (cost inputs)
To facilitate the translation of strategies and services into resource requirements and financial costs, the WHO-CHOICE team has developed a range of databases that provide country-specific estimates. Here you can access estimated costs for one inpatient bed day, one outpatient visit at different levels of the health system, salaries, meeting costs, and much more.
WHO has a longstanding experience in producing global price tags. Taking a strong health system perspective, the models are set up to run country-by-country and year-by-year. Estimations benefit from the databases with country-specific prices. Recent publications include global price tags for the health SDGs and for Primary Health Care.
The 2010 World Health Report suggested that between 20% and 40% of all health resources might be lost to various forms of inefficiency. Under the WHO-CHOICE programme, allocative efficiency is analyzed from the perspective of cost-effectiveness analysis (and occasionally cost-benefit analysis). The work on technical efficiency is closely linked to the work on costing, since sources of inefficiency often relate to the cost-drivers in health systems and the largest categories of health spending: medicines, health workforce, and health infrastructure, particularly hospitals. Cost data that reflect the current use of available resources can inform a dialogue on whether these can be spent more efficiently.
The OneHealth Tool is a software tool designed to inform national strategic health planning in low- and middle-income countries. It allows for detailed estimation of resource needs and related costs. WHO supports countries to use this tool to assess costs related to health service packages and health investment strategies.
AccessMod is a toolbox that has been developed by WHO in order to assist countries to examine the geographic aspects of their health system. It specifically addresses the first three layers of a well-known framework developed by Tanahashi (1978) to evaluate health service coverage (the specific three layers being: the target population, availability coverage and accessibility coverage).
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