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Standard Treatment Guidelines and Costing
Health systems, particularly in
developing countries are faced with burgeoning health needs on one hand and
limited resources on the other. Policy makers at various levels are engaged
in developing cost-effective health interventions that ensure accessible and
affordable quality care that concurrently serves the poor and vulnerable groups.
They are also increasingly functioning as purchasers of care. To enable
evidence based decision making, it is critical that they have information
about the nature of costs incurred for providing services as per Standard
Treatment Guidelines (STGs). Such information on
costing of health services would help in estimating the amount of resources
required to provide healthcare services, ensure better monitoring and
decision making in terms of enhancing efficiency and effectiveness in
delivery of healthcare services. Information on range of costs of healthcare
services could become a base for negotiating with the healthcare provider on
the payment mechanisms in health insurance and any other healthcare
purchasing mechanisms.
In India, while several studies have
attempted to examine the issue of costing of health services there exist
inadequate information on how much it would cost to provide services as per
Standard Treatment Guidelines across different levels of care. This aspect
would be helpful in estimating standard cost of health services, which could
be used for the purpose of health insurance or any other provider payment
mechanism followed in the country.
With this in view, the WHO
Country Office collaborated with the Ministry of Health and Family Welfare,
Govt. of India and the Armed
Forces Medical
College to develop STGs and thereafter, estimate the costs incurred for
provision of treatment as per Standard Treatment Guidelines (STGs) for select 35 conditions, across four levels of
care. The levels of care were: solo physician clinic; 6-10 bedded health
facility; 30-100 bedded health facility and 100 or more bedded health
facility. In India,
efforts at undertaking costing of STGs are at a
nascent stage and require further refinement, in terms of methodology to be
used. This study is a beginning in this area, any comments and suggestions to
improve the study methodology, data sources or cost estimates are most
welcome.
The estimated costs for provision
of treatment as per Standard Treatment Guidelines are merely indicative,
based on the methodology used. There would be cost variations if different
parameters / methodology are used. The costs sheets provided (in MS Excel)
could be modified by any user, to suit their need or context by altering any
of the assumptions and rates provided. In spite on the lacunae inherent with
undertaking such an exercise, it does provide us information about the range
of costs that could be incurred at a defined level of health care facility,
when a standard treatment guideline is adhered to. These guidelines and their
costing is free to distribute, with due acknowledgement. It is envisaged that
with increased used, there could be further improvement in costing of STG,
which would help contribute towards improved patient care.
 Reports
Useful
Links
National Health Programmes
 National Guidelines on
Prevention, Management and Control of Reproductive Tract Infections including
Sexually Transmitted Infections
Learning Material on Leprosy
for Capacity Building on District Nucleus Staff and Medical Officers working
in Hospital/PHC/CHC and Dispensaries
Revised National Tuberculosis Control Programme
National Vector Borne Disease Control Programme
National AIDS Control Programme
Reproductive and Child Health Programme
States
Chhattisgarh
Uttar Pradesh
Karnataka
Rajasthan
Tamil Nadu
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