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The Tuberculosis Epidemic in Romania : TB Allocative Efficiency Model Findings and Recommendations (English)

This report summarizes the findings of an allocative efficiency study of Romania's Tuberculosis (TB) response, which was conducted using the Optima-TB model. The analysis was conducted to support Romania in its decision-making on strategic TB investments during the current National Strategic Plan for the Control of Tuberculosis in Romania (NSP, 2015‒20) and up to 2030. The analysis highlights the potential for Romania to maximize its impact on the TB response by reallocating spending on unnecessary hospitalization to increase the coverage of ambulatory care, treatment of drug-resistant TB and enhanced and active case finding in congregate community settings and high-risk areas.

Details

  • Author

    Socaci,Adriana, Mahler-Boca,Beatrice, Chiotan, Domnica Ioana, Popescu,Gilda, Stefan,Mihaela, Cioran,Nicoleta, Benedikt,Clemens Johannes, Cheikh,Nejma, Fraser-Hurt,Nicole, Shubber,Zara, Abersuriya,Romesh, Kedziora,David, Martin-Hughes,Rowan, Aboujaoude,Gerard Joseph, Abubakar,Ibrahim, Gosce,Lara, Haghparast-Bidgoli,Hassan, Palmer,Tom, Skordis-Worrall,Jolene

  • Document Date

    2019/06/01

  • Document Type

    Report

  • Report Number

    142699

  • Volume No

    1

  • Total Volume(s)

    2

  • Country

    Romania,

  • Region

    Europe and Central Asia,

  • Disclosure Date

    2019/10/17

  • Disclosure Status

    Disclosed

  • Doc Name

    The Tuberculosis Epidemic in Romania : TB Allocative Efficiency Model Findings and Recommendations

  • Keywords

    allocative efficiency; sputum smear microscopy; Acquired Immune Deficiency Syndrome; funding mechanism; national institute of statistic; life expectancy at birth; allocation of resource; latent tb; national strategic; diagnosis and treatment; improved treatment outcome; treatment outcomes; case findings; allocation of expenditure; allocation of fund; optimal allocation; reallocation of fund; source of financing; higher value use; efficacy of treatment; health information system; million people; country of birth; center for health; provision of treatment; movement of people; efficacy of vaccination; passive case finding; public health problem; health insurance fund; Health Service Delivery; privileges and immunity; level of support; stage of disease; clinical infectious disease; randomized controlled trials; drug regimen; treatment regimen; base year; current expenditure; smear positive; ambulatory treatment; case detection; mathematical model; epidemic trajectory; drug resistant; demographic trend; treatment intervention; general population; epidemiological parameters; treatment adherence; symptom screening; latent infection; drug resistance; community intervention; high-risk group; homeless people; Rural Poor; nosocomial transmission; children of ages; financial incentive; annual expenditure; expenditure amount; cost data; funding source; smear negative; peer support; chest x-ray; disease progression; marginal return; adult population; outcome data; new cases; policy question; disease burden; targeted population; progression rate; outreach activity; population target; population size; equity argument; education campaign; multidrug-resistant tuberculosis; treatment failure; high-risk population; national population; sensitivity analysis; demographic data; prevalence survey; active infection; housing condition; recovery rate; initial screening; cost treatment; monitoring cost; treatment programmes; expenditure analysis; model calibration; treatment expenditure; significant challenge; hospital funding; allocation pattern; epidemiological data; budget increase; eligible patients; latent tuberculosis; parameter value; outcome targets; population group; census surveys; test methods; early identification; differential equation; financial resource; diagnostic method; external source; innovative research; new technology; study group; government experts; Ageing Population; international funding; increased demand; domestic sources; legislative change; community-based programs; rural area; patient share; stated objective; Health Workers; tuberculosis treatment; health condition; input data; health finance; empirical estimate; budget datum; household population; calibration process; protective efficacy; markov chain; uncertainty analysis; accurate estimate; treatment effectiveness; population optima; hiv positive; population structure; latent state; individual study; diminishing return; new infections; national insurance; tuberculosis surveillance; available evidence; world population; pulmonary tuberculosis; natural history; paradigm shift; active tuberculosis; under treatment; resource optimization; hiv epidemic; tuberculosis patients; culture conversion; Antiretroviral therapies; antiretroviral therapy; tuberculosis screening; mission statement; average cost; recent years; human rights; treatment modalities; literature review; drug price; screening programs; bottom-up approach; expenditure area; outpatient treatment; drug-resistant case; hospital data; agreed amount; health facility; outpatient service; female prisoner; patient adherence; epidemic indicators; case notifications; base case; outcome indicator; minimum level; future price; short period; several areas; budget allocation; health outcome; decision science; temporal trends; child population; long-term projection; resource availability; living condition; ambulatory care; national school; state funding; rifampicin resistance; dna sequence; government funding; optimization model

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Citation

Socaci,Adriana Mahler-Boca,Beatrice Chiotan, Domnica Ioana Popescu,Gilda Stefan,Mihaela Cioran,Nicoleta Benedikt,Clemens Johannes Cheikh,Nejma Fraser-Hurt,Nicole Shubber,Zara Abersuriya,Romesh Kedziora,David Martin-Hughes,Rowan Aboujaoude,Gerard Joseph Abubakar,Ibrahim Gosce,Lara Haghparast-Bidgoli,Hassan Palmer,Tom Skordis-Worrall,Jolene

The Tuberculosis Epidemic in Romania : TB Allocative Efficiency Model Findings and Recommendations (English). Washington, D.C. : World Bank Group. http://documents.worldbank.org/curated/en/989311571338054208/The-Tuberculosis-Epidemic-in-Romania-TB-Allocative-Efficiency-Model-Findings-and-Recommendations