Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of Bhutan
Abstract Background Village health workers (VHWs) in Bhutan play an all-encompassing role in supporting the health of their communities. Recent reports from the Bhutan Ministry of Health have indicated a sharp reduction in the number of working VHWs. As such, our work attempts to estimate the cost s...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | BMC Public Health |
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| Online Access: | http://link.springer.com/article/10.1186/s12889-020-09347-4 |
| _version_ | 1828901330991710208 |
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| author | Sacha C. Hauc Dolley Tshering Josemari Feliciano Agata M. P. Atayde Layla M. Aboukhater Kinley Dorjee Tshering Dukpa Pema Rinchen Neema Yoezer Casey M. Luc Rup N. Adhikari Kezang Lhamo Kaveh Khoshnood |
| author_facet | Sacha C. Hauc Dolley Tshering Josemari Feliciano Agata M. P. Atayde Layla M. Aboukhater Kinley Dorjee Tshering Dukpa Pema Rinchen Neema Yoezer Casey M. Luc Rup N. Adhikari Kezang Lhamo Kaveh Khoshnood |
| author_sort | Sacha C. Hauc |
| collection | DOAJ |
| description | Abstract Background Village health workers (VHWs) in Bhutan play an all-encompassing role in supporting the health of their communities. Recent reports from the Bhutan Ministry of Health have indicated a sharp reduction in the number of working VHWs. As such, our work attempts to estimate the cost saved and the number of averted hospital admissions onto the Bhutanese healthcare system and the individuals who are served by these health workers. Methods We utilized a dataset from the Bhutan Ministry of Health which encompassed over 95% of all reported disease cases within the nation. We examined the impact that VHWs have on hospital admission rates for eight diseases of interest by using multiple multivariate logistic regression models. Our model allowed us to estimate the potential disease cases averted when the average number of VHWs per health center is increased by one unit. Lastly, we utilized the 2011 “A Costing of Healthcare Services in Bhutan” to estimate the cost saved attributed to VHWs. Results An average one unit increase of VHWs per health center is associated with a decrease in hospital and clinic admission for diarrhea, dysentery, wound care, depression/anxiety, dental caries, and skin infection, while a non-significant increase was observed for scabies and conjunctivitis. These findings translate to 4604 outpatient visits averted, with $28,637 saved, and 78 inpatient visits averted, with $10,711 saved. These values sum to a total of 4682 yearly averted admissions at health centers, with a total cost savings of $39,348 yearly. Additionally, we estimated a yearly savings of $13,348 in transportation costs and a total of $20,960 saved in wages to the community members that VHWs serve. Conclusions VHWs serve as a source of cost-savings for the Kingdom of Bhutan and also act as an economic buffer for more vulnerable communities. The cost-savings associated with these health workers is likely to become more pertinent as the nation begins to develop and healthcare costs increase. It is imperative that proper action be taken to retain these health workers as every VHW who leaves the program increases healthcare costs onto the Bhutanese government. |
| first_indexed | 2024-12-13T15:59:39Z |
| format | Article |
| id | doaj.art-8d501e57c1fe4a659da9414e79373a13 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-13T15:59:39Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-8d501e57c1fe4a659da9414e79373a132022-12-21T23:39:13ZengBMCBMC Public Health1471-24582020-08-012011710.1186/s12889-020-09347-4Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of BhutanSacha C. Hauc0Dolley Tshering1Josemari Feliciano2Agata M. P. Atayde3Layla M. Aboukhater4Kinley Dorjee5Tshering Dukpa6Pema Rinchen7Neema Yoezer8Casey M. Luc9Rup N. Adhikari10Kezang Lhamo11Kaveh Khoshnood12Yale University School of Public Health, Laboratory of Epidemiology and Public HealthBhutan Ministry of HealthYale University School of Public Health, Laboratory of Epidemiology and Public HealthBoston CollegeBoston CollegeBhutan Ministry of HealthKhesar Gyalpo University of Medical Sciences of BhutanKhesar Gyalpo University of Medical Sciences of BhutanKhesar Gyalpo University of Medical Sciences of BhutanYale University School of Public Health, Laboratory of Epidemiology and Public HealthBhutan Ministry of HealthBhutan Ministry of HealthYale University School of Public Health, Laboratory of Epidemiology and Public HealthAbstract Background Village health workers (VHWs) in Bhutan play an all-encompassing role in supporting the health of their communities. Recent reports from the Bhutan Ministry of Health have indicated a sharp reduction in the number of working VHWs. As such, our work attempts to estimate the cost saved and the number of averted hospital admissions onto the Bhutanese healthcare system and the individuals who are served by these health workers. Methods We utilized a dataset from the Bhutan Ministry of Health which encompassed over 95% of all reported disease cases within the nation. We examined the impact that VHWs have on hospital admission rates for eight diseases of interest by using multiple multivariate logistic regression models. Our model allowed us to estimate the potential disease cases averted when the average number of VHWs per health center is increased by one unit. Lastly, we utilized the 2011 “A Costing of Healthcare Services in Bhutan” to estimate the cost saved attributed to VHWs. Results An average one unit increase of VHWs per health center is associated with a decrease in hospital and clinic admission for diarrhea, dysentery, wound care, depression/anxiety, dental caries, and skin infection, while a non-significant increase was observed for scabies and conjunctivitis. These findings translate to 4604 outpatient visits averted, with $28,637 saved, and 78 inpatient visits averted, with $10,711 saved. These values sum to a total of 4682 yearly averted admissions at health centers, with a total cost savings of $39,348 yearly. Additionally, we estimated a yearly savings of $13,348 in transportation costs and a total of $20,960 saved in wages to the community members that VHWs serve. Conclusions VHWs serve as a source of cost-savings for the Kingdom of Bhutan and also act as an economic buffer for more vulnerable communities. The cost-savings associated with these health workers is likely to become more pertinent as the nation begins to develop and healthcare costs increase. It is imperative that proper action be taken to retain these health workers as every VHW who leaves the program increases healthcare costs onto the Bhutanese government.http://link.springer.com/article/10.1186/s12889-020-09347-4Community health workerBhutanVillage health workerHospital admissions |
| spellingShingle | Sacha C. Hauc Dolley Tshering Josemari Feliciano Agata M. P. Atayde Layla M. Aboukhater Kinley Dorjee Tshering Dukpa Pema Rinchen Neema Yoezer Casey M. Luc Rup N. Adhikari Kezang Lhamo Kaveh Khoshnood Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of Bhutan BMC Public Health Community health worker Bhutan Village health worker Hospital admissions |
| title | Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of Bhutan |
| title_full | Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of Bhutan |
| title_fullStr | Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of Bhutan |
| title_full_unstemmed | Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of Bhutan |
| title_short | Evaluating the effect of village health workers on hospital admission rates and their economic impact in the Kingdom of Bhutan |
| title_sort | evaluating the effect of village health workers on hospital admission rates and their economic impact in the kingdom of bhutan |
| topic | Community health worker Bhutan Village health worker Hospital admissions |
| url | http://link.springer.com/article/10.1186/s12889-020-09347-4 |
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