| บทคัดย่อ(English) |
This cross sectional study analyzes the cost of HIV/AIDS activities at thehealth center level that is nearest to people in the service area. Theobjective of this study is to identify the component costs, estimate cost of theexisting package and then compare an improved integrated core package of HIV/AIDSactivities to the existing package of HIV/AIDS activities. Integrated core package oressential health package can be defined as health care services that are consideredimportant and that society decides should be provided to everyone. An integrated corepackage is modified from the existing package of HIV/AIDS activities by consideringexpert opinion, stakeholder or action groups authority, state of the art, nationalpolicy and guidelines. Values such as equity, quality, cost-effectiveness, ortransparency underlie these concepts. The research was conducted to analyze cost to the provider including: 1)capital cost that clarified to cost of building, equipment. vehicle, and humancapital, and 2) recurrent cost that clarified to labor cost and supply cost. Providercost of the existing package and an integrated core package of HIV/AIDS activitiesare derived into five categories as follow; 1) palliative care. 2) MCH, 3) HHC or homevisitation, 4) MIS and paperwork, and 5) health education and health promotion. In thisstudy, the proportion of health personnel time, medical supply for HIV/AIDS is thereal proportion. The proportion for other components such as building. equipment,vehicle, non-medical supply is a rough proportion obtained from number of HIV visitsover number of total visits. The study shows that the total cost of the new package, total cost of allactivities including improved HIV/AIDS activities is 10% higher than the existinghealth package. The total cost of an integrated core package for HIV/AIDS activitiesis 3.4 times higher than the existing package of HIV/AIDS activities. The cost of theHIV/AIDS package is 5% of the health package for an existing package and 16% for thenew integrated core package. Some costs could be switched from the hospital to thehealth center. They are still financed by government. The real additional cost overthe cost of an integrated health package is 1:10. The real additional cost of anintegrated core package of HIV/AIDS activities is 1,093 Baht per PWA or 33 Baht percapita. The cost of the new health package is 358 Baht per capita. The proportion costof HIV/AIDS activities over health package is 5% for an existing package rising to10% for an integrated core package with real additional cost. The cost of the newpackage is affordable and could be financed by the government. |
