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Cost implications of improving the quality of child care using integrated clinical algorithms: Evidence from Northeast Brazil

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  • Adam, Taghreed
  • Edwards, Sally J.
  • Amorim, Débora G.
  • Amaral, João
  • Victora, Cesar G.
  • Evans, David B.

Abstract

Objectives Previous research has shown that providers trained in the Integrated Management of Childhood Illness offered higher quality care for under-fives than those providing routine care in several settings including Northeast Brazil. The objective of this paper is to examine if such quality improvements adds to total costs or is cost saving.Methods The additional costs associated with treating children based on IMCI clinical algorithms in northeast Brazil are estimated by comparing the total costs of under-five care in 22 municipalities with IMCI with 22 matched municipalities providing routine care. Multivariate analysis was also used to isolate the effect of IMCI on costs at primary facilities, controlling for other possible determinants.Results For 2001, there was no statistically significant difference in the cost per child of caring for under-fives in IMCI municipalities (US$ 95) relative to the comparison municipalities (US$ 98). Moreover, IMCI training had no independent effect on unit costs at primary facilities, the largest component in overall costs per child (79%). Case load was the most important determinant.Conclusion Our findings suggest that scaling up IMCI-based care could increase child health outcomes in Brazil without increasing overall health costs.

Suggested Citation

  • Adam, Taghreed & Edwards, Sally J. & Amorim, Débora G. & Amaral, João & Victora, Cesar G. & Evans, David B., 2009. "Cost implications of improving the quality of child care using integrated clinical algorithms: Evidence from Northeast Brazil," Health Policy, Elsevier, vol. 89(1), pages 97-106, January.
    • Handle: RePEc:eee:hepoli:v:89:y:2009:i:1:p:97-106
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    1. World Bank, 2002. "World Development Indicators 2002," World Bank Publications - Books, The World Bank Group, number 13921, December.
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    Cited by:

    1. Shankar Prinja & Pankaj Bahuguna & Pavitra Mohan & Sarmila Mazumder & Sunita Taneja & Nita Bhandari & Henri van den Hombergh & Rajesh Kumar, 2016. "Cost Effectiveness of Implementing Integrated Management of Neonatal and Childhood Illnesses Program in District Faridabad, India," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-19, January.
    2. Ahmed, Haitham M. & Mitchell, Marc & Hedt, Bethany, 2010. "National implementation of Integrated Management of Childhood Illness (IMCI): Policy constraints and strategies," Health Policy, Elsevier, vol. 96(2), pages 128-133, July.

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