Collecting unit cost data in multicentre studies
Tóm tắt
International comparisons of health care systems and services have created increased interest in the comparability of cost results. This study compared top-down and bottom-up approaches to collecting unit cost data across centres in the context of examining the cost-effectiveness of dialysis therapy across Europe. The study tested whether health care technologies in different countries can be costed using consistent and transparent methods to increase the comparability of results. There was more agreement across the approaches for peritoneal dialysis than for than haemodialysis, with differences, respectively of €91–1,687 vs. 333–7,314 per patient per year. Haemodialysis results showed greatest differences where dialysis units were integrated as part of larger hospitals. Deciding which approach to adopt depends largely on the technology. However, bottom-up costing should be considered for technologies with a large component of staff input or overheads, significant sharing of staff or facilities between technologies or patient groups and health care costing systems which do not routinely allocate costs to the intervention level. In these circumstances this costing approach could increase consistency and transparency and hence comparability of cost results.
Tài liệu tham khảo
Parkin DW, McGuire AJ, Yule BF (1989) What do international comparisons of health care expenditures really show? Community Med 11: 116–123
Willke RJ, Glick HA, Polsky D, Schulman K (1998) Estimating country-specific cost-effectiveness from multinational clinical trials. Health Econ 7: 481–493
Schulman K, Burke J, Drummond M et al. (1998) Resource costing for multinational neurologic clinical trials: methods and results. Health Econ 7: 629–638
Koopmanschap MA, Touw KCR, Rutten FFH (2001) Analysis of costs and cost-effectiveness in multinational trials. Health Policy 58: 175–186
Raikou M, Briggs A, Gray A, McGuire A (2000) Centre specific or average unit costs in multi-centre studies? Some theory and simulation. Health Econ 9: 191–198
Johnston K, Gerard K, Brown J (1998) Generalizing costs from trials. Int J Technol Assess Health Care 14: 3 494–504
Cook JR, Drummond M, Glick H, Heyes JF (2003) Assessing the appropriateness of combining economic data from multinational clinical trials. Stat Med 2: 1955–1976
Spath HM, Carrere M-O, Fervers B, Philip T (1999) Analysis of the eligibility of published economic evaluations to a given health care system. Health Policy 49: 161–177
Brouwer W, Rutten F, Koopmanscap (2001) Costing in economic evaluations. In: Economic evaluation in health acre: merging theory with practice. Oxford University Press: Oxford
Malik NP (1999) Haemodialysis. Lancet 353: 737
Drummond MF, O’Brien B, Stoddart GL, Torrance G (1997) Methods for the economic evaluation of health care programmes. Oxford University Press: Oxford
Gokal R (1999) Peritoneal dialysis. Lancet 353: 823