RT Journal Article
SR Electronic
T1 Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam
JF Global Health: Science and Practice
JO GLOB HEALTH SCI PRACT
FD Johns Hopkins University- Global Health. Bloomberg School of Public Health, Center for Communication Programs
SP e2200008
DO 10.9745/GHSP-D-22-00008
VO 10
IS 4
A1 Lora L. Sabin
A1 Aldina Mesic
A1 Bao Ngoc Le
A1 Nafisa Halim
A1 Chi Thi Hue Cao
A1 Rachael Bonawitz
A1 Ha Viet Nguyen
A1 Anna Larson
A1 Tam Thi Thanh Nguyen
A1 Anh Ngoc Le
A1 Christopher J. Gill
YR 2022
UL http://www.ghspjournal.org/content/10/4/e2200008.abstract
AB Key FindingsThis study found that a highly successful phone-based continuing medical education (CME) intervention for HIV clinicians in northern Vietnam was relatively low-cost and cost-effective when costs were compared to benefits.Forecasted future models that spread fixed costs over expanded nationwide versions of the program are even more appealing from a cost perspective.These findings suggest that mobile approaches to CME can be quite cost-effective and are worthy of attention in resource-constrained settings.Key ImplicationsPolicy makers and national stakeholders should consider alternatives to traditional in-person CME, including mobile approaches (based on text messages) that are convenient for participants, effective, and relatively low cost to implement.Policy makers in resource-constrained environments should consider investing in innovative and cost-effective mobile phone-based CME on a long-term and widespread basis given that such strategies may have considerable set-up costs but can motivate clinicians to improve self-study habits and increase knowledge in critical ways.Background:The Mobile Continuing Medical Education (mCME) 2.0 project was a randomized controlled trial that found that a 6-month text message-based CME intervention improved both the use of online medical training resources and medical knowledge among a cadre of HIV clinicians in Vietnam. This companion study analyzed intervention costs and cost-effectiveness.Methods:We conducted (1) a financial analysis based on costs incurred during the trial’s planning and implementation; (2) an economic analysis to consider resource utilization; and (3) cost-effectiveness analyses to estimate cost inputs relative to impact: increase in self-study (measured by visits to online courses) and increase in knowledge (measured by exam score improvement) (in 2016 US$). Finally, we estimated the economic cost of a 9-month national program and a 10-year scaled-up model (in 2021 US$).Results:The total financial cost of the intervention was US$49,552; the main cost drivers were personnel time (71.4%) and technology inputs (14.9%). The total economic cost was estimated at US$92,212, with the same key cost inputs (representing 77.7% and 8.0%, respectively, of total costs). The financial cost per 10% increase in accessing online courses was US$923, while the cost of improving knowledge, measured by a 10% improvement in mean exam score across the study population, was US$32,057 (US$605 per intervention clinician). The comparable total economic cost of each improvement, respectively, was US$1,770 and US$61,452 (US$1,159 per intervention clinician). A future 9-month national program was estimated to cost US$37,403, while the full 10-year scaled-up program was estimated at US$196,446.Conclusions:This analysis indicates that leveraging mobile technology could be a feasible way to provide distance learning to health professions across Vietnam at a relatively low cost. Given the need for practical ways to expand CME in resource-constrained regions of the world, this approach warrants further study and possible adoption.