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Costs of Hypertension and Diabetes Treatment Cascade in Tunisia

Washington, DC: World Bank

🛡CC BY-NC 3.0 IGOUso permitido com atribuição

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Tamanho: 637,4 KB
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↗Será aberto no site de origem: World Bank Open Knowledge Repository

Fonte: World Bank Open Knowledge Repository ↗ · Relatar problema

Compartilhado porSandeep Chatterjee›

Resumo

Hypertension and type 2 diabetes are highly prevalent in Tunisia and among the most costly conditions for the health system and the economy. This study estimates the costs of prevention, diagnosis, outpatient follow up, and inpatient care for complications across all levels of care to identify cost drivers and inefficiencies, support revision of insurance reimbursement, and standardize Ministry of Health costing. Direct costs were calculated from patient medical files using activity based costing and indirect costs from facility utilization and budget data using a top down approach, with population data used to project national costs. Prevention and screening costs are modest per person, but financing gaps for outreach and consumables limit coverage. In primary care, annual costs vary by pathway, sector, insurance status, and location, with higher adherence and higher costs in private offices and among controlled patients, indicating that improved follow up and laboratory access can improve outcomes cost effectively. Hospital analyses show large avoidable costs associated with late diagnosis and inefficient referral patterns. Findings also reveal inequities across facilities. Total annual costs are estimated at TD 2.2 billion, and substantial savings are achievable through stronger prevention, better outpatient case management, more efficient inpatient care, and provider payment reform.