Handbook of Economic Evaluation of HIV Prevention ProgramsDavid R. Holtgrave Springer Science & Business Media, 31.10.1998 г. - 282 страници If resources for HIV prevention efforts were truly unlimited, then this book would be en tirely unnecessary. In a world with limitless support for HIV prevention activities, one would simply implement all effective (or potentially effective) programs without regard to expense. We would do everything useful to prevent the further spread of the virus that has already claimed hundreds of thousands of lives in the United States and millions of lives worldwide. Unfortunately, funding for HIV prevention programs is limited. Even though the amount of available funding may seem quite large (especially in the United States), it is still fixed and not sufficient to meet all needs for such programs. This was very well illustrated in the summer of 1997 when over 500 community-based organizations applied for a combined total of $18 million of HIV prevention funding from the U.S. Centers for Disease Control and Prevention (CDC). Less than one-fifth ofthese organizations received support via this funding mechanism. Hence, although $18 million may seem like a large amount of money at first blush, it is not enough to meet all of the prevention needs that could be addressed by these community-based organizations. |
Съдържание
An Overview of Economic Evaluation Methodologies and Selected Issues in Methods Standardization | 1 |
A Review of Economic Evaluation Concepts | 2 |
Major Recommendations Particularly Relevant to AIDS Prevention | 3 |
CostUtility Analysis and Quality of Life Measurement | 4 |
Measuring Costs | 5 |
Relevance for AIDS Research | 6 |
Relevance to AIDS Prevention | 9 |
Conclusions | 10 |
Descriptive Models | 147 |
Prescriptive Models in Action | 148 |
References | 149 |
Economic Evaluation and HIV Prevention Decision Making The State Perspective | 153 |
Federal Leadership and Direction | 154 |
Existing Economic Evaluations of HIV Prevention Programs | 155 |
Barriers to Use of Cost Effectiveness and CostEffectiveness Information by States | 156 |
Lack of InHouse Scientific Expertise in Cost and Effectiveness Evaluation | 157 |
References | 11 |
The BernoulliProcess Model of HIV Transmission Applications and Implications | 13 |
The BernoulliProcess Model | 14 |
Results from the Basic Model | 16 |
Bernoulli Model of Secondary Transmission | 22 |
Notes on Model Parameters Approximations and Variants | 23 |
Estimating Intervention Effectiveness | 27 |
Summary Limitations and Future Directions | 29 |
References | 31 |
Assessing the CostEffectiveness of HIV Prevention Interventions A Primer | 33 |
Assessing the Cost of the Intervention | 34 |
Estimating the Number of Infections Averted | 35 |
HIVAIDSAssociated Medical Treatment Costs and QALYs Saved | 36 |
Combining Parameters and Performing Sensitivity Analysis | 38 |
Summary | 39 |
References | 41 |
Economic Evaluation of Primary HIV Prevention in Injection Drug Users | 45 |
Preview of Chapter | 46 |
Ongoing Research | 56 |
Future Directions | 57 |
Methodological Issues | 58 |
Substantive Issues | 59 |
References | 61 |
Economic Evaluation of HIV Counseling and Testing Programs The Influence of Program Goals on Evaluation | 63 |
The Goals of HIV Counseling and Testing | 65 |
The Literature Survey | 67 |
Results of the Survey | 70 |
Discussion and Policy Analysis | 73 |
References | 75 |
Economic Evaluation of HIV Screening Interventions | 81 |
The Benefit of Early Medical Intervention | 83 |
Effect of Screening on HighRisk Behavior | 84 |
Rationale for Screening | 85 |
Summary and Implications | 89 |
Economic Analyses | 90 |
Summary and Implications | 92 |
Screening of HealthCare Workers | 93 |
Economic Analyses | 94 |
Summary and Implications | 96 |
References | 97 |
Changing Public Policy to Prevent HIV Transmission The Role of Structural and Environmental Interventions | 103 |
Theoretical Considerations | 104 |
Medical Anthropology and Sociology | 105 |
Structural and Environmental Interventions | 107 |
Structural and Environmental Determinants of HIV Transmission | 108 |
Migration Urbanization and Family Disruption | 109 |
Structural and Environmental Interventions for AIDS Prevention | 110 |
Stimulating Policy Change | 113 |
Discussion and Recommendations | 114 |
References | 115 |
The CostEffectiveness of Small Group and CommunityLevel Interventions | 119 |
Economic Evaluations of Small Group and CommunityLevel Interventions | 120 |
Small Group Intervention for AtRisk Women | 121 |
HIV Prevention Skills Training for Men Who Have Sex with Men | 122 |
Safer Sex Diffusion within a Community of Gay Men | 123 |
Summary | 124 |
References | 125 |
The CostEffectiveness of the Components of a Comprehensive HIV Prevention Program A Road Map of the Literature | 127 |
HIV Counseling Testing Referral and Partner Notification | 128 |
Health Education and Risk Reduction | 129 |
Public Information Mass Media and Social Marketing | 130 |
Syringe Exchange Referral to Drug Treatment and Street and Community Outreach | 131 |
Perinatal Transmission Prevention | 132 |
Conclusions | 133 |
Resource Allocation and the Funding of HIV Prevention | 135 |
The Theory of Resource Allocation | 136 |
The Critical Ratio | 137 |
Obstacles to Estimating the Threshold CostEffectiveness Ratio | 138 |
League Tables | 139 |
Practical Approaches to Drawing the Line | 141 |
Blame and Controllability | 143 |
Identifiable Lives and the Rule of Rescue | 144 |
The Role of Formal Analysis | 145 |
Studies Views of Interventions in Isolation | 158 |
Connecticuts Experience in Cost and Effectiveness Evaluations and in Use of Cost and Effectiveness Data | 159 |
Conclusions | 160 |
References | 161 |
Adapting Cost Analytic Techniques to Local HIV Prevention Programs | 163 |
CEA and the Houston Community Planning Process | 164 |
Methods for Assessing Effectiveness | 166 |
Methods for Assessing the Unit Costs of Interventions | 168 |
A Spreadsheet Approach | 171 |
Conclusion and Future Research | 173 |
References | 175 |
Economic Evaluation and HIV Prevention Community Planning A Policy Analysts Perspective | 177 |
Community Planning as Resource Allocation | 178 |
Production Functions for HIV Prevention | 179 |
Estimating Baseline HIV Incidence | 180 |
Assessing the Relative Impact of HIV Prevention | 181 |
Allocating HIV Prevention Resources | 184 |
Optimal Resource Allocation | 186 |
Valuation of Social Constraints | 188 |
Decisions Must be Made | 191 |
References | 192 |
Threshold Analysis of AIDS Outreach and Intervention | 195 |
Methodological Framework | 197 |
Data Collection | 198 |
Description of the Sample | 199 |
Methods | 200 |
Benefits | 202 |
Results | 203 |
Sensitivity of Results to Different Assumptions | 205 |
Conclusion | 207 |
References | 208 |
A Few Reflections on the Practicality of Economic Evaluation Methods and Conclusions | 211 |
Experience with HIV Prevention Community Planning | 212 |
Expressing Prevention Needs | 213 |
Comparing Services in Terms of Costs | 214 |
References | 215 |
A Method to Measure the Costs of Counseling for HIV Prevention | 217 |
Overview of a Cost Analysis | 218 |
Determination of Counseling Costs | 219 |
Inventorying the Resources Required | 220 |
Calculating the Total and Expected Cost of the Intervention | 225 |
Discussion | 226 |
Suggested Readings | 227 |
228 | |
Updates of Cost of Illness and Quality of Life Estimates for Use in Economic Evaluations of HIV Prevention Programs | 229 |
Methods | 231 |
Reasons for Updating T and Q Parameters | 232 |
Scenario Analysis | 233 |
Results | 237 |
Discussion | 238 |
References | 240 |
CostEffectiveness of a Community Level HIV Risk Reduction Intervention | 243 |
Description of Intervention | 244 |
CostEffectiveness | 245 |
Retrospective Cost Estimation | 246 |
Mathematical Modeling | 248 |
Estimation of QALYs Saved | 250 |
Calculation of CostEffectiveness and CostUtility Ratios | 251 |
Results | 252 |
CostEffectiveness and CostUtility Ratios | 253 |
Threshold and Sensitivity Analyses | 254 |
Discussion | 256 |
References | 257 |
HIV Prevention and CostEffectiveness Resources on the World Wide Web | 261 |
General Interest HIVAIDS Sites | 262 |
Sites with Prevention Resources and Information | 264 |
Sites for Economic Population and HealthCare Information and Data | 265 |
US Government Sites for Information and Data Not Listed Previously | 266 |
Other Sites of Interest | 270 |
Sites for Relevant Journals | 272 |
275 | |
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