Health Economics Research at Department of Community Medicine & School of Public Health PGIMER,Chandigarh
Cost Effectiveness Of Dimagi’s Commcare Program For Improving Maternal & Child Health Care
Principal Investigator Dr Shankar Prinja
Funding agency United States Agency for International Development
Brief Summary The main objectives of the study are to assess the effectiveness of using the CommCare tool in Kaushambi district, to assess the health system cost of using the CommCare tool in delivering maternal and child health services. To assess the cost-effectiveness analysis of using the CommCare tool in terms of incremental cost per DALY averted against a counterfactual scenario of routine MNCH health care delivery in Kaushambi district of UP state.
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The Impact Of Road Traffic Injury: A Mixed Methods Study In North India
Principal Investigator Dr Shankar Prinja
Funding agency Road Traffic Injuries Research Network
Brief Summary This prospective observational study aimed to estimate the impact of road traffic injury in patients presenting at a tertiary care and two secondary care health facilities in north India.The main objectives were to measure the impact of road traffic injuries on function and health-related quality-of-life (HRQoL) in urban settings in India, to measure the social impact of road traffic injuries on victims and their families including their participation and utilization of health and social services; and to measure the economic cost of traffic crashes using the human capital approach, including direct and indirect costs to individuals and their families.
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Cost Outcome description of Liver ICU treatment in a Tertiary Care Hospital
Principal Investigator Dr Shankar Prinja
Funding agency PGIMER Chandigarh
Brief Summary The aim of the research is to perform a cost-outcome analysis using the expected remaining life-years in survivors after 18 months of discharge from ICU. We aim to analyze the health system as well as individual patient-related cost of hepatic intensive care with economic perspective for different group of diseases at various follow up periods to accomplish set objectives. These objectives are to ascertain unit cost per hospital survivor at 1.5 years of discharge, to ascertain cost per Healthy life year gained at 1.5 years of discharge and to ascertain unit health system as well as patient related costs of getting intensive care in HICU.
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Costing of primary and secondary health services in North India
Principal investigator Dr. Shankar Prinja
Funding agency PGIMER Chandigarh
Brief Summary In this study costing of treatment, care and preventive services at one purposively selected district hospital, two primary health centres (PHC), two community health centres (CHC) and 6 sub-centres, in the states of Haryana and Himachal Pradesh was undertaken. The main objectives of this study were to ascertain the per unit health system costs at primary and secondary level in India, to compute unit cost estimates for primary and secondary level care, by type of services and to estimate the incremental cost of implementing IPHS standards at primary and secondary level at district level in India. The bottom up costing approach was used in our study. Data on resources utilized and prices was collected for one complete year, which best represented the implementation of program.
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Social & Economic Impact of Road Traffic Injuries in India
Principal Investigator Dr. Shankar Prinja
Funding agency George Institute, Hyderabad
Brief Summary This study aimed to estimate the impact of road traffic injury in patients presenting at a tertiary care and two secondary care health facilities in north India. A total of 227 patients who were admitted for at least one night in a tertiary care hospital of Chandigarh were recruited. Data were collected on the type of injury, OOP expenditure and its coping mechanisms. Cases were followed-up at 1st, 2nd and 12th month after discharge to collect information on OOP expenditure.
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Concurrent Evaluation of NRHM: Haryana Health Survey (ongoing)
Principal investigator Dr Shankar Prinja
Funding agency National Rural Health Mission (NRHM), Haryana
Brief Summary National Rural Health Mission (NRHM) was launched in 2005 to improve the health status of people who live in rural areas. India is steadily heading towards attaining the goals set out by the NRHM. DLHS/AHS does not provide data at block, PHC or sub-centre level to identify pockets within a district with poor performance. Hence, there is a need for generation of data at more frequent intervals by an independent agency to identify community development blocks, PHCs and sub-centres which need further strengthening in health care delivery. Keeping this in mind the main objectives of this study were set. These are to assess the coverage of RCH and curative care services, at district and block level, in Haryana, to assess coverage of various social determinants such as water and sanitation, education, welfare services etc, to validate the quality of routine health information system, to assess the effectiveness of interventions being undertaken to strengthen health system in Haryana and to ascertain the extent of universal health coverage in Haryana.
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Evaluation of Referral Transport Services in Punjab
Principal investigator Dr Shankar Prinja
Funding agency National Health Systems Resource Centre, New Delhi
Brief Summary This study evaluated the Punjab 108 referral service for extent and pattern of utilization, quality and efficiency of service, impact of service on improving institutional delivery rates in public sector and health system cost for providing the service.
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Costing of Special Care Newborn Units in India
Principal investigator Dr Shankar Prinja
Funding agency UNICEF
Brief Summary This study estimated the health system ‘per neonate treatment cost’ and ‘per-bed-day treatment cost’ in district-hospital based SCNUs in India. Bottom-up economic costing methodology was adopted. Health system resources, i.e. capital, equipment, drugs and consumables, non-consumables, referral and overheads, utilized to treat all neonates during 2010 were elicited. Additionally, 360 randomly selected treatment files of neonates were screened to estimate direct out-of-pocket (OOP) expenditure borne by the patients. In order to account for variability in prices and other parameters, we undertook a univariate sensitivity analysis.
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Cost Effectiveness of IMNCI Program in India
Principal investigator Dr Shankar Prinja
Funding agency The study was funded by the World Health Organization, Geneva (through an umbrella grant from USAID); the United Nations Children’s Fund, New Delhi; and the GLOBVAC Program of the Research Council of Norway.
Brief Summary We used a bottom-up ingredients approach to estimate the economic cost of child health care services delivered by the primary care workers, with and without IMNCI. Trained field investigators, with graduate-level qualification, collected the data on resources, i.e. building space, equipment’s, salary and any incentives or allowance for human resources, medicines, vaccines, oher consumables and diagnostics for 1 year, i.e. 2010.
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Impact Assessment of Targeted Interventions on HIV in India
Principal investigator Dr Rajesh Kumar
Funding agency National AIDS Control Organization, New Delhi
Brief Summary As part of the Mid-Term Review of National AIDS Control Program phase-3, we evaluated the cost effectiveness of India’s targeted preventive interventions for HIV in India. A compartmental mathematical Markov state model was used over a 20-year time horizon (1995- 2015) to estimate the cost effectiveness of FSW targeted interventions, with a health system perspective. The incremental costs and effects of FSW targeted interventions were compared against a baseline scenario of mass media for the general population alone.
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Evaluation of Referral Transport Services in Haryana
Principal investigator Dr Shankar Prinja
Funding agency National Health Systems Resource Centre, New Delhi
Brief Summary Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency.
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Health Inequities in Three Northern Indian States: Role of Public Sector
Principal investigator Dr Shankar Prinja
Funding agency London School of Economics and Political Science
Brief Summary Income inequality is associated with poor health. Inequities exist in service utilization and financing for health care. Health care costs push high number of households into poverty in India. We undertook this study to ascertain inequities in health status, service utilization and out-of- pocket (OOP) health expenditures in two States in north India namely, Haryana and Punjab, and Union Territory of Chandigarh. Inequities are ascertained in three dimensions i.e. horizontal, vertical and redistribution.
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Evaluation of ICDS program in Chandigarh
Co-investigator Dr Shankar Prinja
Funding agency Social Welfare Department, Chandigarh
Brief Summary The main objectives of this study were to evaluate the coverage of delivery of nutritional, maternal and child health services under the ICDS scheme, to assess growth monitoring of 0-6 year old children and compare with records. Also it included objectives to assess the nature and extent of functional integration in infrastructure, planning, service delivery, monitoring & evaluation between ICDS and health and to ascertain the extent of decentralization and community participation in the planning, implementation and monitoring of services at Anganwadi centers. A systematic multistage stratified random sampling was used for selection of AWCs. In each ICDS project area, 10% AWCs was selected with probability proportional to size (PPS) using the data available from Department of Women and Child Development, Chandigarh. Hence, a total of 34 AWCs were selected for the detailed study.
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Impact of user charges on service utilization in Haryana
Principal investigator Dr Shankar Prinja
Funding agency Ford Foundation IAPSM grant
Brief Summary In this study the impact of user charges was evaluated on the inpatient hospitalization rate in Haryana State. It was also assessed whether the impact of user charges on service utilization was equitable according to income, gender and geographic region, and the vertical equity in out-of-pocket spending at public sector health institutions was ascertained in districts with and without user charges. The present study was conducted during November 2007 to June 2008, when inpatient utilization records from 2000 to 2006 were collected.
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