Variable | Base | Range | Distribution | Reference |
Population | ||||
Population of children under 5 years in representative rural municipality | 1904 | 280–6883 | Normal | †39 |
Population of children under 5 years in Aklan‡ | 2318 | NA | NA | †39 40 |
Population of children under 5 years in Nueva Ecija‡ | 2424 | NA | NA | †39 40 |
Undiscounted life expectancy at 3 years | 69 | 65.55–72.45* | Normal | 58 |
Epidemiology | ||||
Pneumonia | ||||
Probability of getting pneumonia in representative rural municipality | 0.1028 | 0.0838–0.1233 | Beta | 23 |
Probability of getting pneumonia in Aklan‡ | 0.1301 | NA | NA | †22 23 59 |
Probability of getting pneumonia in Nueva Ecija‡ | 0.0502 | NA | NA | †22 23 59 |
Proportion of cases that are severe | 0.10 | 0.05–0.15* | Beta | 41 |
Diarrhoea | ||||
Probability of getting diarrhoea in representative rural municipality | 0.7379 | 0.6835–0.7928 | Beta | 23 |
Probability of getting diarrhoea in Aklan‡ | 0.5863 | NA | NA | †22 23 59 |
Probability of getting diarrhoea in Nueva Ecija‡ | 0.4872 | NA | NA | †22 23 59 |
Proportion of cases that are moderate | 0.347 | 0.10–0.4995* | Beta | 42 |
Proportion of cases that are severe | 0.5 | 0.05–0.10* | Beta | 42 |
Annual transition probabilities | ||||
Pneumonia | ||||
Probability of dying at age three for causes other than pneumonia | 0.004 | 0.0038–0.0041 | Beta | †60 |
Probability of seeking treatment given mild disease | 0.89 | 0.50–1* | Beta | 61 |
Probability of dying with treatment of mild disease | 0.035 | 0.0263–0.0438* | Beta | 43 44 |
Probability of dying without treatment of mild disease | 0.05 | 0.02–0.065* | Beta | 44 |
Probability of seeking treatment given severe disease | 0.91 | 0.50–1* | Beta | 61 |
Probability of dying without treatment of severe disease | 0.21 | 0.05–0.25* | Beta | 44 |
Probability of dying with treatment of severe disease | 0.1477 | 0.110–0.184* | Beta | 43 44 |
Diarrhoea | ||||
Probability of dying at age 3 for causes other than diarrhoea | 0.0046 | 0.0045–0.0047 | Beta | †60 |
Probability of seeking treatment given mild disease | 0.4175 | 0.362–0.447 | Beta | †62 |
Probability of dying given no treatment of mild disease | 0.0018 | 0.0012–0.0027 | Beta | 46 |
Probability of dying with treatment of mild disease | 0.0012 | 0.0009–0.0014* | Beta | 45 46 |
Probability of seeking treatment given moderate disease | 0.4175 | 0.362–0.447 | Beta | †62 |
Probability of dying given no treatment of moderate disease | 0.0018 | 0.0012–0.0027 | Beta | 46 |
Probability of dying with treatment of mild disease | 0.0012 | 0.0009–0.0014* | Beta | 45 46 |
Probability of seeking treatment given severe disease | 0.4175 | 0.362–0.447 | Beta | †62 |
Probability of dying given no treatment of severe disease | 0.0058 | 0.0039–0.0087 | Beta | 46 |
Probability of dying given treatment of severe disease | 0.0014 | 0.001–0.0022 | Beta | 45 46 |
Treatment | ||||
Probability that doctor is at the RHU with DTTB | 0.9 | 0.8–1 | Beta | Expert opinion |
Probability that doctor is at the RHU without DTTB§ | 0.15 | 0.075–0.225* | Beta | Expert opinion |
Probability that patient is treated when doctor is present | 0.75 | 0.50–1 | Beta | Expert opinion; FHSIS |
Probability that patient has other source of care when doctor is not present¶ | 0.8 | 0.7–1* | Beta | Expert opinion; FHSIS |
Probability that patient is treated by other source of care when doctor is not present | 0.75 | 0.50–1 | Beta | Assumed by authors |
Costs (in 2017 PHP)** | ||||
Pneumonia | ||||
Societal cost of treating severe pneumonia episode | 48 721 | 33 395–64300 | Gamma | †49–51 |
Healthcare cost of treating severe pneumonia episode | 47 101 | 32 577–61626 | Gamma | †49–51 |
Societal cost of treating mild pneumonia episode | 6765 | 4694–7457 | Gamma | †49 50 62 |
Healthcare cost of treating mild pneumonia episode | 5485 | 4377–6582 | Gamma | †49 50 62 |
Diarrhoea | ||||
Societal cost of treating a mild diarrhoea episode | 6765 | 5343–8222 | Gamma | †49 51 62 |
Healthcare cost of treating a mild diarrhoea episode | 6457 | 5165–7748 | Gamma | †49 51 62 |
Societal cost of treating a moderate diarrhoea episode | 11 960 | 6629–17363 | Gamma | †49 62 |
Healthcare cost of treating a moderate diarrhoea episode | 11 406 | 6323–16488 | Gamma | †49 62 |
Societal cost of treating a severe diarrhoea episode | 27 575 | 19 949–35617 | Gamma | †49 62 63 |
Healthcare cost of treating a severe diarrhoea episode | 25 709 | 19 234–32183 | Gamma | †49 62 63 |
Other costs (discounted) | ||||
Lifetime consumption (in thousands) | 1697 | 1079–2817 | Gamma | 64 |
Lifetime productivity (in thousands) | 2235 | 1406–3830 | Gamma | 64 |
Human resources (in thousands) | ||||
Annual cost of deploying a DTTB physician | 1721 | 1500–2500 | Gamma | DoH data |
Annual cost of MHO or RHP hired locally by municipality | 926 | 880–976 | Gamma | DBM data† |
Utilities | ||||
Alive | 1 | 0.9–1 | Beta | Assumed by authors |
Dead | 0 | NA | NA | Assumed by authors |
Discount rate | 0.03 | 0.02–0.08 | NA | Assumed by authors |
*Value assumed or set by authors.
†Base value and range calculated by authors based on the references cited.
‡No ranges and distributions are specified because only base case analyses were conducted using these data.
§Municipalities who do not participate in DTTB may still successfully hire a full-time physician to work as a RHP or MHO, or occasionally receive temporary physicians deployed by the provincial government or by a non-governmental organisation.
¶In many rural and underserved municipalities, RHUs are the only source of care, though some communities have privately practicing physicians or district hospitals nearby.
**Details behind cost calculations are found in the online supplementary file 1.
DBM, Department of Budget and Management; DoH, Department of Health; DTTB, Doctors to the Barrios; FHSIS, Field Health Services Information System; MHO, municipal health officer; NA, not applicable; PHP, Philippine pesos;RHP, rural health physician; RHU, rural health unit.