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Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review

BACKGROUND: Historically, the focus of cost-effectiveness analyses has been on the costs to operate and deliver interventions after their initial design and launch. The costs related to design and implementation of interventions have often been omitted. Ignoring these costs leads to an underestimati...

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Autores principales: Malhotra, Akash, Thompson, Ryan R., Kagoya, Faith, Masiye, Felix, Mbewe, Peter, Mosepele, Mosepele, Phiri, Jane, Sambo, Jairos, Barker, Abigail, Cameron, Drew B., Davila-Roman, Victor G., Effah, William, Hutchinson, Brian, Laxy, Michael, Newsome, Brad, Watkins, David, Sohn, Hojoon, Dowdy, David W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670396/
https://www.ncbi.nlm.nih.gov/pubmed/36384807
http://dx.doi.org/10.1186/s13012-022-01248-x
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author Malhotra, Akash
Thompson, Ryan R.
Kagoya, Faith
Masiye, Felix
Mbewe, Peter
Mosepele, Mosepele
Phiri, Jane
Sambo, Jairos
Barker, Abigail
Cameron, Drew B.
Davila-Roman, Victor G.
Effah, William
Hutchinson, Brian
Laxy, Michael
Newsome, Brad
Watkins, David
Sohn, Hojoon
Dowdy, David W.
author_facet Malhotra, Akash
Thompson, Ryan R.
Kagoya, Faith
Masiye, Felix
Mbewe, Peter
Mosepele, Mosepele
Phiri, Jane
Sambo, Jairos
Barker, Abigail
Cameron, Drew B.
Davila-Roman, Victor G.
Effah, William
Hutchinson, Brian
Laxy, Michael
Newsome, Brad
Watkins, David
Sohn, Hojoon
Dowdy, David W.
author_sort Malhotra, Akash
collection PubMed
description BACKGROUND: Historically, the focus of cost-effectiveness analyses has been on the costs to operate and deliver interventions after their initial design and launch. The costs related to design and implementation of interventions have often been omitted. Ignoring these costs leads to an underestimation of the true price of interventions and biases economic analyses toward favoring new interventions. This is especially true in low- and middle-income countries (LMICs), where implementation may require substantial up-front investment. This scoping review was conducted to explore the topics, depth, and availability of scientific literature on integrating implementation science into economic evaluations of health interventions in LMICs. METHODS: We searched Web of Science and PubMed for papers published between January 1, 2010, and December 31, 2021, that included components of both implementation science and economic evaluation. Studies from LMICs were prioritized for review, but papers from high-income countries were included if their methodology/findings were relevant to LMIC settings. RESULTS: Six thousand nine hundred eighty-six studies were screened, of which 55 were included in full-text review and 23 selected for inclusion and data extraction. Most papers were theoretical, though some focused on a single disease or disease subset, including: mental health (n = 5), HIV (n = 3), tuberculosis (n = 3), and diabetes (n = 2). Manuscripts included a mix of methodology papers, empirical studies, and other (e.g., narrative) reviews. Authorship of the included literature was skewed toward high-income settings, with 22 of the 23 papers featuring first and senior authors from high-income countries. Of nine empirical studies included, no consistent implementation cost outcomes were measured, and only four could be mapped to an existing costing or implementation framework. There was also substantial heterogeneity across studies in how implementation costs were defined, and the methods used to collect them. CONCLUSION: A sparse but growing literature explores the intersection of implementation science and economic evaluation. Key needs include more research in LMICs, greater consensus on the definition of implementation costs, standardized methods to collect such costs, and identifying outcomes of greatest relevance. Addressing these gaps will result in stronger links between implementation science and economic evaluation and will create more robust and accurate estimates of intervention costs. TRIAL REGISTRATION: The protocol for this manuscript was published on the Open Science Framework. It is available at: https://osf.io/ms5fa/ (DOI: 10.17605/OSF.IO/32EPJ). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13012-022-01248-x.
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spelling pubmed-96703962022-11-18 Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review Malhotra, Akash Thompson, Ryan R. Kagoya, Faith Masiye, Felix Mbewe, Peter Mosepele, Mosepele Phiri, Jane Sambo, Jairos Barker, Abigail Cameron, Drew B. Davila-Roman, Victor G. Effah, William Hutchinson, Brian Laxy, Michael Newsome, Brad Watkins, David Sohn, Hojoon Dowdy, David W. Implement Sci Systematic Review BACKGROUND: Historically, the focus of cost-effectiveness analyses has been on the costs to operate and deliver interventions after their initial design and launch. The costs related to design and implementation of interventions have often been omitted. Ignoring these costs leads to an underestimation of the true price of interventions and biases economic analyses toward favoring new interventions. This is especially true in low- and middle-income countries (LMICs), where implementation may require substantial up-front investment. This scoping review was conducted to explore the topics, depth, and availability of scientific literature on integrating implementation science into economic evaluations of health interventions in LMICs. METHODS: We searched Web of Science and PubMed for papers published between January 1, 2010, and December 31, 2021, that included components of both implementation science and economic evaluation. Studies from LMICs were prioritized for review, but papers from high-income countries were included if their methodology/findings were relevant to LMIC settings. RESULTS: Six thousand nine hundred eighty-six studies were screened, of which 55 were included in full-text review and 23 selected for inclusion and data extraction. Most papers were theoretical, though some focused on a single disease or disease subset, including: mental health (n = 5), HIV (n = 3), tuberculosis (n = 3), and diabetes (n = 2). Manuscripts included a mix of methodology papers, empirical studies, and other (e.g., narrative) reviews. Authorship of the included literature was skewed toward high-income settings, with 22 of the 23 papers featuring first and senior authors from high-income countries. Of nine empirical studies included, no consistent implementation cost outcomes were measured, and only four could be mapped to an existing costing or implementation framework. There was also substantial heterogeneity across studies in how implementation costs were defined, and the methods used to collect them. CONCLUSION: A sparse but growing literature explores the intersection of implementation science and economic evaluation. Key needs include more research in LMICs, greater consensus on the definition of implementation costs, standardized methods to collect such costs, and identifying outcomes of greatest relevance. Addressing these gaps will result in stronger links between implementation science and economic evaluation and will create more robust and accurate estimates of intervention costs. TRIAL REGISTRATION: The protocol for this manuscript was published on the Open Science Framework. It is available at: https://osf.io/ms5fa/ (DOI: 10.17605/OSF.IO/32EPJ). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13012-022-01248-x. BioMed Central 2022-11-16 /pmc/articles/PMC9670396/ /pubmed/36384807 http://dx.doi.org/10.1186/s13012-022-01248-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Systematic Review
Malhotra, Akash
Thompson, Ryan R.
Kagoya, Faith
Masiye, Felix
Mbewe, Peter
Mosepele, Mosepele
Phiri, Jane
Sambo, Jairos
Barker, Abigail
Cameron, Drew B.
Davila-Roman, Victor G.
Effah, William
Hutchinson, Brian
Laxy, Michael
Newsome, Brad
Watkins, David
Sohn, Hojoon
Dowdy, David W.
Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
title Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
title_full Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
title_fullStr Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
title_full_unstemmed Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
title_short Economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
title_sort economic evaluation of implementation science outcomes in low- and middle-income countries: a scoping review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670396/
https://www.ncbi.nlm.nih.gov/pubmed/36384807
http://dx.doi.org/10.1186/s13012-022-01248-x
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