Handbook of Economic Evaluation of HIV Prevention Programs

Предна корица
David 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
References
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
Index
275
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