Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries
<strong>Objectives</strong> COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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BMJ Publishing Group
2021
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| _version_ | 1826293899414470656 |
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| author | Torres-Rueda, S Sweeney, S Bozzani, F Naylor, NR Baker, T Pearson, C Eggo, R Procter, SR Davies, N Quaife, M Kitson, N Keogh-Brown, MR Jensen, HT Saadi, N Khan, M Huda, M Kairu, A Zaidi, R Barasa, E Jit, M Vassall, A |
| author_facet | Torres-Rueda, S Sweeney, S Bozzani, F Naylor, NR Baker, T Pearson, C Eggo, R Procter, SR Davies, N Quaife, M Kitson, N Keogh-Brown, MR Jensen, HT Saadi, N Khan, M Huda, M Kairu, A Zaidi, R Barasa, E Jit, M Vassall, A |
| author_sort | Torres-Rueda, S |
| collection | OXFORD |
| description | <strong>Objectives</strong> COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios.
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<strong>Methods</strong> We used country-specific epidemiological projections from a dynamic transmission model to determine number of cases, hospitalisations and deaths over 1 year under four mitigation scenarios. We defined the health sector response for three base LMICs through guidelines and expert opinion. We calculated costs through local resource use and price data and extrapolated costs across 79 LMICs. Lastly, we compared cost estimates against gross domestic product (GDP) and total annual health expenditure in 76 LMICs.
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<strong>Results</strong> COVID-19 clinical management costs vary greatly by country, ranging between <0.1%–12% of GDP and 0.4%–223% of total annual health expenditure (excluding out-of-pocket payments). Without mitigation policies, COVID-19 clinical management costs per capita range from 43.39 to 75.57 US dollars; in 22 of 76 LMICs, these costs would surpass total annual health expenditure. In a scenario of stringent social distancing, costs per capita fall to 1.10–1.32 US dollars.
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<strong>Conclusions</strong> We present the first dataset of COVID-19 clinical management costs across LMICs. These costs can be used to inform decision-making on priority setting. Our results show that COVID-19 clinical management costs in LMICs are substantial, even in scenarios of moderate social distancing. Low-income countries are particularly vulnerable and some will struggle to cope with almost any epidemiological scenario. The choices facing LMICs are likely to remain stark and emergency financial support will be needed. |
| first_indexed | 2024-03-07T03:37:17Z |
| format | Journal article |
| id | oxford-uuid:bcb88589-4de5-4031-80f7-afeaa95d6cd0 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T03:37:17Z |
| publishDate | 2021 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:bcb88589-4de5-4031-80f7-afeaa95d6cd02022-03-27T05:26:30ZStark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bcb88589-4de5-4031-80f7-afeaa95d6cd0EnglishSymplectic ElementsBMJ Publishing Group2021Torres-Rueda, SSweeney, SBozzani, FNaylor, NRBaker, TPearson, CEggo, RProcter, SRDavies, NQuaife, MKitson, NKeogh-Brown, MRJensen, HTSaadi, NKhan, MHuda, MKairu, AZaidi, RBarasa, EJit, MVassall, A<strong>Objectives</strong> COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under different epidemiological scenarios. <br> <strong>Methods</strong> We used country-specific epidemiological projections from a dynamic transmission model to determine number of cases, hospitalisations and deaths over 1 year under four mitigation scenarios. We defined the health sector response for three base LMICs through guidelines and expert opinion. We calculated costs through local resource use and price data and extrapolated costs across 79 LMICs. Lastly, we compared cost estimates against gross domestic product (GDP) and total annual health expenditure in 76 LMICs. <br> <strong>Results</strong> COVID-19 clinical management costs vary greatly by country, ranging between <0.1%–12% of GDP and 0.4%–223% of total annual health expenditure (excluding out-of-pocket payments). Without mitigation policies, COVID-19 clinical management costs per capita range from 43.39 to 75.57 US dollars; in 22 of 76 LMICs, these costs would surpass total annual health expenditure. In a scenario of stringent social distancing, costs per capita fall to 1.10–1.32 US dollars. <br> <strong>Conclusions</strong> We present the first dataset of COVID-19 clinical management costs across LMICs. These costs can be used to inform decision-making on priority setting. Our results show that COVID-19 clinical management costs in LMICs are substantial, even in scenarios of moderate social distancing. Low-income countries are particularly vulnerable and some will struggle to cope with almost any epidemiological scenario. The choices facing LMICs are likely to remain stark and emergency financial support will be needed. |
| spellingShingle | Torres-Rueda, S Sweeney, S Bozzani, F Naylor, NR Baker, T Pearson, C Eggo, R Procter, SR Davies, N Quaife, M Kitson, N Keogh-Brown, MR Jensen, HT Saadi, N Khan, M Huda, M Kairu, A Zaidi, R Barasa, E Jit, M Vassall, A Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_full | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_fullStr | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_full_unstemmed | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_short | Stark choices: exploring health sector costs of policy responses to COVID-19 in low-income and middle-income countries |
| title_sort | stark choices exploring health sector costs of policy responses to covid 19 in low income and middle income countries |
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