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Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa

BACKGROUND: The National Department of Health of South Africa decided to start a programme to train mid-level healthcare workers, called clinical associates, as one of the measures to increase healthcare workers at district level in rural areas. Unfortunately, very little is known about the cost eff...

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Autores principales: Hamm, Joris, van Bodegraven, Petra, Bac, Martin, Louw, Jakobus M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AOSIS 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125259/
https://www.ncbi.nlm.nih.gov/pubmed/28155324
http://dx.doi.org/10.4102/phcfm.v8i1.1218
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author Hamm, Joris
van Bodegraven, Petra
Bac, Martin
Louw, Jakobus M.
author_facet Hamm, Joris
van Bodegraven, Petra
Bac, Martin
Louw, Jakobus M.
author_sort Hamm, Joris
collection PubMed
description BACKGROUND: The National Department of Health of South Africa decided to start a programme to train mid-level healthcare workers, called clinical associates, as one of the measures to increase healthcare workers at district level in rural areas. Unfortunately, very little is known about the cost effectiveness of clinical associates. AIMS: To determine, on a provincial level, the cost effectiveness of training and employing clinical associates and medical practitioners compared to the standard strategy of training and employing only more medical practitioners. METHODS: A literature study was performed to answer several sub questions regarding the costs and effectiveness of clinical associates. The results were used to present a case study. RESULTS: The total cost for a province to pay for the full training of a clinical associate is R 300 850. The average employment cost per year is R196 329 and for medical practitioners these costs are R 730 985 and R 559 397, respectively. EFFECTIVENESS: Clinical associates are likely to free up the time of a medical practitioner by 50–76%. They can provide the same quality of care as higher level workers, provided that they receive adequate training, support and supervision. Furthermore, they seem more willing to work in rural areas compared to medical practitioners. CONCLUSIONS: The case study showed that training and employing clinical associates is potentially a cost-effective strategy for a province to meet the increasing demand for rural healthcare workers. This strategy will only succeed when clinical associates receive adequate training, support and supervision and if the province keeps investing in them.
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spelling pubmed-51252592016-11-29 Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa Hamm, Joris van Bodegraven, Petra Bac, Martin Louw, Jakobus M. Afr J Prim Health Care Fam Med Original Research BACKGROUND: The National Department of Health of South Africa decided to start a programme to train mid-level healthcare workers, called clinical associates, as one of the measures to increase healthcare workers at district level in rural areas. Unfortunately, very little is known about the cost effectiveness of clinical associates. AIMS: To determine, on a provincial level, the cost effectiveness of training and employing clinical associates and medical practitioners compared to the standard strategy of training and employing only more medical practitioners. METHODS: A literature study was performed to answer several sub questions regarding the costs and effectiveness of clinical associates. The results were used to present a case study. RESULTS: The total cost for a province to pay for the full training of a clinical associate is R 300 850. The average employment cost per year is R196 329 and for medical practitioners these costs are R 730 985 and R 559 397, respectively. EFFECTIVENESS: Clinical associates are likely to free up the time of a medical practitioner by 50–76%. They can provide the same quality of care as higher level workers, provided that they receive adequate training, support and supervision. Furthermore, they seem more willing to work in rural areas compared to medical practitioners. CONCLUSIONS: The case study showed that training and employing clinical associates is potentially a cost-effective strategy for a province to meet the increasing demand for rural healthcare workers. This strategy will only succeed when clinical associates receive adequate training, support and supervision and if the province keeps investing in them. AOSIS 2016-11-15 /pmc/articles/PMC5125259/ /pubmed/28155324 http://dx.doi.org/10.4102/phcfm.v8i1.1218 Text en © 2016. The Authors http://creativecommons.org/licenses/by/2.0/ AOSIS. This work is licensed under the Creative Commons Attribution License.
spellingShingle Original Research
Hamm, Joris
van Bodegraven, Petra
Bac, Martin
Louw, Jakobus M.
Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa
title Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa
title_full Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa
title_fullStr Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa
title_full_unstemmed Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa
title_short Cost effectiveness of clinical associates: A case study for the Mpumalanga province in South Africa
title_sort cost effectiveness of clinical associates: a case study for the mpumalanga province in south africa
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5125259/
https://www.ncbi.nlm.nih.gov/pubmed/28155324
http://dx.doi.org/10.4102/phcfm.v8i1.1218
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