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Franchise Evaluation
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Presentation Transcript

  1. Franchise Evaluation Study priorities Global Health Group University of California, San Francisco November 20, 2008

  2. Health Franchise Programs Current None Unknown status

  3. Determining what we want to know • Operations, finance, and economics • Cost-effectiveness? • Difference in incentive/financing models? • What structures work best? • Quality, equity, and access • Increasing access to underserved populations? • Improved quality and service delivery?

  4. Study methods • Case studies • Cross-sectional surveys • Case-control • Randomized, non-randomized • By clinic, district • Before/after studies • Data collected prior to launching of new franchise or service • Prospective/retrospective longitudinal analysis

  5. Qualitative methods • Focus groups • In-depth interviews • Observation • Ethnographic research

  6. Existing tools • StarScan (MSI): Adherence to franchisee agreement • Monthly franchisee reports (PSI) • Rapid Assessment Audit Tool (PSI) • Clinic records (financial, services, clientele)

  7. Tools: Monitoring quality • Mystery client • Exit interviews • Quality Technical Assistance review (MSI) • Surprise inspections (PSI) • Facility assessment (Clincscan/MSI) • Observation

  8. Program outcomes • CYP • 1.4M CYP (GreenStar Pakistan) • Cost per CYP • $8 (GreenStar) • DALYs • 72,009 DALYs (New Start South Africa) • Sustainability

  9. Defining key terms • What do we mean by… • a clinical franchise? • Increased access? • Improved quality?

  10. Indicators • Clients served and demographics • Products and services sold • Quality of care (client satisfaction, compliance with standards) • CYP • DALY • Cost recovery, cost effectiveness

  11. Small group discussion • What are the priority issues for further research? What do we want to learn? • What are possible study designs? • What are the key indicators?