Promising healthcare solutions - Getting at what really works
Indicators of performance in cost, health outputs, efficiency, and even sustainability
Since CHMI’s last call for Reported Results, one month ago, 47 programs have reported new indicators of performance, bringing the total number of programs with reported results to 149. We asked program managers to tell us what they know about their performance in up to ten key dimensions.
Rather than simply collecting results from programs that had been evaluated, we asked managers to report all available information on performance—data that is often collected internally but rarely reported and shared.
Below are examples of three programs tracking how well they are working to improve health care for the poor, and excerpts of their Reported Results that illustrate how they are tracking their performance.
Naya Jeevan, a hybrid social enterprise providing low income families in Pakistan with insurance, has reported results in seven of ten categories, including sustainability, a category in which only 17 programs have reported results.
Decrease in Cost: The annual cost of the Naya Jeevan integrated health plan is approximately US$24 per person, per year, as compared to the standard rates charged by commercial insurers of about US$50/person/year.
Sustainability: The operational revenue increased by 350% between 2010 and 2011; earned income increased from PKR 291,568 in 2010 to PKR 1,076,028 in 2011. Naya Jeevan's donor base also increased to 5 institutional donors and approximately 100 major individual donors in 2011, compared to 2 institutional donors and 50 individual ones in 2010.
Improvements in Efficiency: Naya Jeevan's operating cost/life impacted has decreased from US$8/life impacted in 2010 to US$6/life impacted in 2011; and should continue to do so due to increased resource optimization and increased number of beneficiaries/economies of scale.
World Health Partners, the innovative franchise network of rural health providers in northern India, also reports results in seven of ten categories, including results from its new flagship program in Bihar. A central characteristic of this program is its focus on improving the detection and treatment of four focus diseases: tuberculosis, visceral leishmaniasis, childhood pneumonia, and diarrhea. An excerpt from the program’s performance in Uttar Pradesh (UP) and Bihar follows:
Utilization: Rural providers in UP see a 20% increase in overall caseload after joining the franchise network.
Pro-Poor Targeting: World Health Partners reported that 80% of clients served are from the poorest two quintiles, with 50% of total clients coming from the poorest quintile.
Health Outputs: From Bihar, the program reported results from the first six months of 2012 on focus diseases diagnosed and treated, including pneumonia and diarrheal disease, the two leading killers of children under five. Providers saw 44,859 cases of childhood pneumonia and 53,360 cases of diarrheal disease. World Health Partners shops sold 334,611 capsules of amoxicillin for pneumonia treatment and 146,316 packets of oral rehydration solution, as well as 338,214 tablets of Zinc.
MedicallHome is a healthcare company that provides hotline-based services to more than five million people in Mexico. MedicallHome states that of all cases received, approximately two-thirds are resolved over the phone, eliminating the need for a doctor's visit and lifting significant pressure from the healthcare system.
Health Outputs: Providing information on topics ranging from psychiatry to gynecology and pediatrics, MedicallHome refers fewer than one out of five callers to medical care. Forty-three percent of calls were referred to a specialist, while 6% were referred to hospitals and 5% to ambulance services.
Efficiency: MedicallHome reports that savings generated by referring the patient to the appropriate level of care represents an annual savings of approximately $ 19.7 million (7,878 cases with an estimated savings of $2,500 each).
About Reported Results All statements were self-reported to CHMI through a survey mechanism. Click Here to learn more about this initiative and see a full list of results categories and definitions or contact us at chmi@resultsfordevelopment.org.