Table 1.
Case study characteristics
| MERGE (Kufa et al., 2014) | XTEND (Foster et al., 2015) | ECONPOP (Ilboudo et al., 2014) | REMSTART (Mfinanga et al., 2015) | |
|---|---|---|---|---|
| Country | South Africa | South Africa | Burkina Faso | Zambia and Tanzania |
| Aim of study | Implementation and evaluation of an optimized model for scaling up TB/HIV integration at primary care clinics | Evaluation of the implementation of a new TB diagnostic, XPert MTB/RIF | Multidisciplinary study to estimate costs and consequences of abortion | Trial assessing a complex intervention to reduce mortality in ART‐naive patients beginning ART |
| Study design | Cluster‐randomized trial | Cluster‐randomized trial | Cross‐sectional survey | Individually randomized control trial |
| Time frame | Cross‐sectional | Cohort | Cross‐sectional | Longitudinal |
| Sampling for cost data | Convenience sample at study facilities | Random subsample of study‐enrolled patients | Convenience sample at study facilities | All participants at study clinics. Clinics chosen for convenience |
| Location of interview | Facility | Facility | Facility | Facility |
| Sample size | 459 for costs | 351 for costs | 304 for economic study | 1375 for costs |
| 3,478 total for trial | 4,656 total for trial | 1,999 total for trial | ||
| Subgroups (n) | TB only (41) | No TB treatment (302) | Induced (37) | Intervention (684) |
| TB/HIV (119) | Control (691) | |||
| HIV only (299) | Started on treatment (49) | Spontaneous (267) | Tanzania (870) | |
| Zambia (505) | ||||
| OOP cost ingredients | Transport for individual and companion, medicines and consumables, diagnostics, consultation fees, special food/supplements, and inpatient accommodation | Transport for individual and companion, medicines and consumables, diagnostics, consultation fees, special food/supplements, and inpatient accommodation | Medicines and consumables, consultation fees, ultrasound, informal payments, pre‐referral costs, and hospitalization | Transport and ‘other’ costs |
| Recall period (costs) | The last visit to each provider (variable; max 5 months) | The last month | ~1 day (interviewed on discharge) | 1 day (cost of visit only) |
| Household/individual costs | Individual and guardian / caregiver | Individual and guardian / caregiver | Individual | Individual and guardian / caregiver |
| Average length of interview (min) | ~60 | ~45 | ~20 | ~25 |
| Diary/recall | Recall | Recall | Recall | Recall |
| Indirect cost measurement | Human capital approach and income loss | Income loss | None | Human capital approach |
| Additional health services costed | Pharmacy, GP, outpatient hospital, inpatient hospital, and traditional healer | Pharmacy, GP, outpatient hospital, inpatient hospital, and traditional healer | None | None |
| Source of income data | Annual individual income before and after diagnosis | Annual individual income before and after diagnosis | None (GDP per capita used as proxy) | Individual income in last month |
| Interviewers used | Research assistants | Nurses and research assistants | Trained female interviewers | Trained field workers |
| Medium of recording | Paper survey | Electronic survey | Paper survey | Paper survey |
| Average cost (95% CI) | Monthly OOP expenditures: $1.02 ($0.44 ‐ $1.60)Monthly travel costs: $2.31 ($1.75 – $2.87)Monthly food costs: $10.93 ($9.44 – $12.41)Monthly indirect costs: $15.67 ($11.88 – $19.46)Monthly income loss: $25.83 ($16.33 – $35.33)Monthly guardian costs: $6.43 ($4.59 – $8.26)Monthly carer costs: $4.63 ($1.60 – $7.65) | Total OOP expenditures: $111.83Total loan interest: $43.32Total income loss: $54.82Total guardian costs: $32.11Total carer costs: $81.99Total episode cost: $324.07 | Total OOP expenditures: $52.80 ($47.36–$58.24) | OOP expenditures for one visit to study facility: $1.96 ($1.80–$2.13) |
| Average annual income (95% CI) | $2,565 ($2,225 – $2,905) | $1,237 ($1,001 – $1,474) | Not measured (GDP per capita used as proxy) | Tanzania: $244 ($212 – 276) |
| Zambia: $219 ($199–239) | ||||
| National poverty line (USD) | $773 | $773 | $184 | Tanzania: $234 |
| Zambia: $266 | ||||
| GDP per capita (USD) | $6,618 | $6,618 | $531 | Tanzania: $695 |
| Zambia: $1,845 | ||||
| Frequency of catastrophic expenditure at 20% threshold (95% CI) | 40% (36–45%) | 59% (54–65%) | 10% (6–14%) | 4% (3–5%) |
| Minimum sample size required to estimate frequency of catastrophic expenditure with 95% CI | Error margin 5%: 2,282 | Error margin 5%: 1,057 | Error margin 5%: 13,689 | Error margin 5%: 36,504 |
| Error margin 10%: 570 | Error margin 10%: 264 | Error margin 10%: 3,422 | Error margin 10%: 9,126 | |
| Error margin 15%: 254 | Error margin 15%: 117 | Error margin 15%: 1,521 | Error margin 15%: 4,056 |
ART, antiretroviral therapy; OOP, out‐of‐pocket; GDP, gross domestic product; GP, general practitioner.