title: The efficiency of chronic disease care in sub-Saharan Africa.
abstract: The number of people needing chronic disease care is projected to increase in sub-Saharan Africa as a result of expanding human immunodeficiency virus (HIV) treatment coverage, rising life expectancies, and lifestyle changes. Using nationally representative data of healthcare facilities, Di Giorgio et al. found that many HIV clinics in Kenya, Uganda, and Zambia appear to have considerable untapped capacity to provide care for additional patients. These findings highlight the potential for increasing the efficiency of clinical processes for chronic disease care at the facility level. Important questions for future research are how estimates of comparative technical efficiency across facilities change, when they are adjusted for quality of care and the composition of patients by care complexity. Looking ahead, substantial research investment will be needed to ensure that we do not forgo the opportunity to learn how efficiency changes, as chronic care is becoming increasingly differentiated by patient type and integrated across diseases and health systems functions.Please see related article: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0653-z.
authors: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA, 02115, USA.
authors: Pascal
authors: P
authors: Geldsetzer
authors: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA, 02115, USA.
authors: Katrina
authors: K
authors: Ortblad
authors: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA, 02115, USA. tbaernig@hsph.harvard.edu.|Institute of Public Health, Heidelberg University, Im Neuenheimer Feld 324, Heidelberg, 69120, Germany. tbaernig@hsph.harvard.edu.|Africa Health Research Institute, P.O. Box 198, Mtubatuba, 3935, South Africa. tbaernig@hsph.harvard.edu.
authors: Till
authors: T
authors: Bärnighausen
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology / Q000628:therapy*; D015658:HIV Infections / Q000453:epidemiology / Q000628:therapy; D015497:HIV-1; D006801:Humans; D017053:Infection Control / Q000592:standards; D007630:Kenya / Q000453:epidemiology; D015397:Program Evaluation; D014454:Uganda / Q000453:epidemiology; D015024:Zambia / Q000453:epidemiology
keywords: Antiretroviral therapy; Chronic diseases; Differentiated care; Efficiency; HIV; Integrated care; Non-communicable diseases