Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries

Human Resources for Health

Research

Gabriel Seidman¹  Rifat Atun¹ 

[1] Department of Global Health and Population, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, United States of America;

关键词: Task shifting;    Community health workers;    Health systems;    Efficiency;    Cost-effectiveness;    Systematic review;   

DOI  :  10.1186/s12960-017-0200-9

 received in 2016-11-15, accepted in 2017-03-29,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTask shifting has become an increasingly popular way to increase access to health services, especially in low-resource settings. Research has demonstrated that task shifting, including the use of community health workers (CHWs) to deliver care, can improve population health. This systematic review investigates whether task shifting in low-income and middle-income countries (LMICs) results in efficiency improvements by achieving cost savings.MethodsUsing the PRISMA guidelines for systematic reviews, we searched PubMed, Embase, CINAHL, and the Health Economic Evaluation Database on March 22, 2016. We included any original peer-review articles that demonstrated cost impact of a task shifting program in an LMIC.ResultsWe identified 794 articles, of which 34 were included in our study. We found that substantial evidence exists for achieving cost savings and efficiency improvements from task shifting activities related to tuberculosis and HIV/AIDS, and additional evidence exists for the potential to achieve cost savings from activities related to malaria, NCDs, NTDs, childhood illness, and other disease areas, especially at the primary health care and community levels.ConclusionsTask shifting presents a viable option for health system cost savings in LMICs. Going forward, program planners should carefully consider whether task shifting can improve population health and health systems efficiency in their countries, and researchers should investigate whether task shifting can also achieve cost savings for activities related to emerging global health priorities and health systems strengthening activities such as supply chain management or monitoring and evaluation.

【 授权许可】

CC BY   
© The Author(s). 2017