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The evaluation of operating Animal Bite Treatment Centers in the Philippines from a health provider perspective
- Source :
- PLoS ONE, PLoS ONE, Vol 13, Iss 7, p e0199186 (2018)
- Publication Year :
- 2018
- Publisher :
- Public Library of Science (PLoS), 2018.
-
Abstract
- BACKGROUND:The Philippine government has an extensive network of 513 Animal Bite Treatment Centers (ABTCs) to supply rabies post exposure prophylaxis (PEP), reaching over 1 million bite victims in 2016. The network was evaluated using a review of existing national and provincial data, key informant interviews and surveys in sample ABTCs to determine the cost-effectiveness of this network in preventing human rabies deaths. METHODOLOGY AND PRINCIPAL FINDINGS:One urban and one rural ABTC in each of three selected provinces were studied in more detail. PEP delivery generally followed national guidance based on best practices, but there was evidence of operational challenges in supplying all ABTCs with adequate biologics and recently trained staff. Funding was contributed by different levels of government and in some clinics, patients paid for a significant fraction of the total cost. From a health provider perspective including both fixed and variable costs, the average PEP course delivered cost USD 32.91 /patient across urban ABTCs (with higher patient throughput) and USD 57.21 /patient across rural ABTCs. These costs suggests that PEP provision in the Philippines cost USD 37.6 million in 2016, with a cost per life saved of USD 8,290. An analysis of the 2,239 suspected rabies deaths from 2008 to 2016 showed no significant decline, and from 2014-16 an average of 8,534 years of life were lost annually. The incidence of rabies deaths from 2014-16 was not clearly related to the provision of ABTCs (per 100,000 population) or human population density, but deaths were more common in higher income provinces. CONCLUSIONS/SIGNIFICANCE:In the context of comprehensive rabies control (including dog vaccination and public awareness) ways to reduce this high expenditure on PEP should be explored, to most cost-effectively reach the elimination of human rabies deaths. This paper is accompanied by another containing data on the operation of ABTCs network from a patient perspective.
- Subjects :
- Male
Viral Diseases
Philippines
Health Care Providers
Cost-Benefit Analysis
lcsh:Medicine
Social Sciences
Nurses
Geographical Locations
Governments
0302 clinical medicine
Cost of Illness
Zoonoses
Medicine and Health Sciences
Cost of illness
Medicine
Public and Occupational Health
Medical Personnel
Bites and Stings
Dog Diseases
030212 general & internal medicine
lcsh:Science
Child
health care economics and organizations
Mammals
Vaccines
Multidisciplinary
Cost–benefit analysis
Incidence
Incidence (epidemiology)
Vaccination
Eukaryota
Cost-effectiveness analysis
Middle Aged
Vaccination and Immunization
Professions
Infectious Diseases
Child, Preschool
Vertebrates
Female
Post-Exposure Prophylaxis
Research Article
Neglected Tropical Diseases
Adult
Asia
Infectious Disease Control
Adolescent
Rabies
Political Science
Immunology
030231 tropical medicine
Local Governments
03 medical and health sciences
Dogs
Life Expectancy
Animals
Humans
Aged
Prophylaxis
business.industry
lcsh:R
Organisms
Biology and Life Sciences
Community Health Centers
Tropical Diseases
Survival Analysis
Health Care
Rabies Vaccines
People and Places
Amniotes
Health care cost
Life expectancy
lcsh:Q
Population Groupings
Preventive Medicine
business
Healthcare providers
Demography
Subjects
Details
- ISSN :
- 19326203
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- PLOS ONE
- Accession number :
- edsair.doi.dedup.....abccb04c05edd390c8112d3947b34784