Improved calibration estimators for the total cost of health programs and application to immunization in Brazil

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dc.creatorRivera-Rodriguez, Claudia
dc.creatorToscano, Cristiana Maria
dc.creatorResch, Stephen
dc.date.accessioned2024-12-06T11:47:14Z
dc.date.available2024-12-06T11:47:14Z
dc.date.issued2019
dc.description.abstractMulti-stage/level sampling designs have been widely used by survey statisticians as a means of obtaining reliable and efficient estimates at a reasonable implementation cost. This method has been particularly useful in National country-wide surveys to assess the costs of delivering public health programs, which are generally originated in different levels of service management and delivery. Unbiased and efficient estimates of costs are essential to adequately allocate resources and inform policy and planning. In recent years, the global health community has become increasingly interested in estimating the costs of immuniza tion programs. In such programs, part of the cost correspond to vaccines and it is in most countries procured at the central level, while the rest of the costs are incurred in states, municipalities and health facilities, respectively. As such, total program cost is a result of adding these costs, and its variance should account for the relation between the totals at the different levels. An additional challenge is the missing information at the various levels. A variety of methods have been developed to compensate for this missing data. Weighting adjustments are often used to make the estimates consistent with readily-available informa tion. For estimation of total program costs this implies adjusting the estimates at each level to comply with the characteristics of the country. In 2014, A National study to estimate the costs of the Brazilian National Immunization Program was initiated, requested by the Minis try of Health and with the support of international partners. We formulate a quick and useful way to compute the variance and deal with missing values at the various levels. Our approach involves calibrating the weights at each level using additional readily-available information such as the total number of doses administered. Taking the Brazilian immuniza tion costing study as an example, this approach results in substantial gains in both efficiency and precision of the cost estimate.
dc.identifier.citationRIVERA-RODRIGUEZ, Claudia; TOSCANO, Cristiana; RESCH, Stephen. Improved calibration estimators for the total cost of health programs and application to immunization in Brazil. PLoS One, San Francisco, v. 14, n. 3, e0212401, 2019. DOI: 10.1371/journal.pone.0212401. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0212401. Acesso em: 4 dez. 2024.
dc.identifier.doi10.1371/journal.pone.0212401
dc.identifier.issne- 1932-6203
dc.identifier.urihttp://repositorio.bc.ufg.br//handle/ri/26046
dc.language.isoeng
dc.publisher.countryEstados unidos
dc.publisher.departmentInstituto de Patologia Tropical e Saúde Pública - IPTSP (RMG)
dc.rightsAcesso Aberto
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.titleImproved calibration estimators for the total cost of health programs and application to immunization in Brazil
dc.typeArtigo

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