Role of healthcare cost accounting in pricing and reimbursement in low-income and middle-income countries: a scoping review.

OBJECTIVES: Progress towards universal health coverage (UHC) requires evidence-based policy including good quality cost data systems. Establishing these systems can be complex, resource-intensive and take time. This study synthesises evidence on the experiences of low-income and middle-income countries (LMICs) in the institutionalisation of cost data systems to derive lessons for the technical process of price-setting in the context of UHC. DESIGN: A scoping review and narrative synthesis of publicly available information. DATA SOURCES: PubMed, MEDLINE, EconLit, the Web of Science and grey literature searched from January 2000 to April 2021. ELIGIBILITY CRITERIA: English-language papers published since 2000 that identified and/or described development of and/or methods used to estimate or inform national tariffs for hospital reimbursement in LMICs. Papers were screened by two independent reviewers. DATA EXTRACTION AND SYNTHESIS: Extraction was performed by one reviewer and checked by the second reviewer on: the method and outputs of cost data collection; commentary on the use of cost data; description of the technical process of tariff setting; and strengths and challenges of the approach. Evidence was summarised using narrative review. RESULTS: Thirty of 484 papers identified were eligible. Fourteen papers reported on primary cost data collection; 18 papers explained how cost evidence informs tariff-setting. Experience was focused in Asia (n=22) with countries at different stages of developing cost systems. Experiences on cost accounting tend to showcase country costing experiences, methods and implementation. There is little documentation how data have been incorporated into decision making and price setting. Where cost information or cost systems have been used, there is improved transparency in decision making alongside increased efficiency. CONCLUSIONS: There are widely used and accepted methods for generating cost information. Countries need to build sustainable cost systems appropriate to their settings and budgets and adopt transparent processes and methodologies for translating costs into prices

A facile non-photocatalytic technique for hydrogen gas production by hydroelectric cell

Hydrogen gas is a zero-emission fuel for clean environment. In present work a novel environment friendly hydrogen producing technique based on nascently invented Hydroelectric cell has been reported. Hydroelectric cell is one of the unique non-polluting H-2 gas generation methods compared to photo-biosynthesis, photo-electro-catalysis and thermo-chemical etc. Spontaneous dissociation of water molecule by Hydroelectric cell (HEC) has led this study for effective production of hydrogen gas. Moreover, a nanoporous lithium substituted magnesium ferrite used in HEC dissociates water molecule to produce hydrogen without using any electrolyte and light. Ferrite pellet combined with zinc and silver electrodes known as hydroelectric cell produces zinc hydroxide and hydrogen gas as a result of redox reaction. Nanoporous and oxygen deficient ferrite pellet has been synthesised with optimized processing conditions. Maximum average nanopore size distribution has been obtained 3.8 nm by N-2 adsorption-desorption isotherm. Surface dangling bonds of unsaturated cations and oxygen vacancies in ferrite chemidissociate water molecule into hydroxide and hydronium ion. High purity hydrogen gas is produced continuously by applying different external voltage only on hydroelectric cell. Collected gas has been analysed by gas chromatography in comparison to pure reference hydrogen gas. This technique has produced hydrogen in large quantity 1.856 mmol/h compared to existing photocatalytic active ferrite methods. Hydrogen gas generation by HEC is an exclusively facile, low cost and novel technique

Metal Oxide Based Hydroelectric Cell for Electricity Generation by Water Molecule Dissociation without Electrolyte/Acid

Never before has electricity been generated out of metal oxides without using any light (UV/IR), acid, or alkali, but it has been achieved by adding a few drops of water on nanoporous metal oxide based Hydroelectric cell (HEC) at room temperature. Electricity generation has been validated and unified for six different metal oxides based on the principle of water dissociation at oxygen deficient nonporous pellet. The presence of oxygen vacancies on the surface of all metal oxide samples has been confirmed by Raman and Photoluminescence spectroscopy techniques. Tin oxide (SnO2) based HEC has delivered maximum power similar to 16.6 mW in a 4.48 cm(2) cell area with highest current 22.2 mA, approximately 2.075 times higher than reported 8 mA current in ferrite based HEC. Water chemidissociation at metal oxide surface was found to be reinforced predominantly by electronegativity of metal cations and oxygen vacancies on nanoporous surface. Divergent peak current values ranging from 22.2 to 1.1 mA were obtained depending on internal resistance, grain boundary nature, water molecule dissociation capability, and nanopores connectivity in different oxides. Slow diffusion of ions in certain metal oxides due to high impedance of grain boundaries has reduced current as confirmed by dielectric and impedance spectroscopy. Metal oxide HEC provides an ecofriendly, cost-effective, and portable green energy source with almost no running cost

Adaptive health technology assessment to facilitate priority setting in low- and middle-income countries.

INTRODUCTION Traditional health technology assessment (HTA) is a policy-based research process, which aims to improve the efficiency and equity of the healthcare system with the limited financial resources available in healthcare.1 In various countries, traditional HTA has been 'institutionalised'-through the development of dedicated agencies with accepted norms and rules that guide explicit priority setting-over years or decades. These agencies use time-consuming, data intensive and systematic methods and processes which require health economics expertise and resources to make recommendations on how to allocate finite resources.2 There is a growing appetite for HTA and its eventual institutionalisation in low-and-middle income countries (LMICs) driven in part by WHO's recommendation for it to be a critical component to achieving universal health coverage.3 While there are notable LMIC exceptions of introducing and institutionalising HTA (eg, Thailand, Colombia, Brazil and India), others may be constrained by limited technical and administrative capacity, paucity of data, time and governance structures to carry out HTA.4 A more pragmatic approach which we define in this paper as 'adaptive HTA' (aHTA) is one which uses various expedited or flexible methods and processes that are 'fit for purpose' and could help to tackle some of these challenges faced by LMICs. Here, we suggest how policy makers, researchers, clinicians and donors can collaborate and support the development and uptake of aHTA for LMICs to enable expedited evidence-based decision making in these countries as one part of the journey towards HTA institutionalisation