Comparing top-down and bottom-up costing approaches for economic evaluation within social welfare
Comparing top-down and bottom-up costing approaches for economic evaluation within social welfare
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DOI：
10.1007/s10198-010-0257-z
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发表时间：
2011-10-01
影响因子：
4.4
通讯作者：
Olsson, Tina M.
中科院分区：
文献类型：
--
作者：
Olsson, Tina M.
本研究比较了两种方法来估计社会福利干预成本：一个“自上而下”和另一个“自下而上”的一组社会福利客户参与一个随机试验的严重问题行为。干预成本范围超过两年的时间进行了比较干预类别（寄养安置，机构安置，辅导服务，个人支持服务和结构化的支持服务），估计方法（价格，微观成本，平均成本）和治疗组（干预，控制）。分析依据的是2007年接受404项干预措施的156人的费用。总体而言，这两种方法被认为是在组的水平，但不是在个人层面上的干预成本产生可靠的估计。由于方法的选择会对平均差的估计产生很大影响，因此应将基于估计方法的调整纳入敏感性分析。在经济评估中选择成本计算方法时，分析人员必须注意评估分析的目的和角度。
This study compares two approaches to the estimation of social welfare intervention costs: one "top-down" and the other "bottom-up" for a group of social welfare clients with severe problem behavior participating in a randomized trial. Intervention costs ranging over a two-year period were compared by intervention category (foster care placement, institutional placement, mentorship services, individual support services and structured support services), estimation method (price, micro costing, average cost) and treatment group (intervention, control). Analyses are based upon 2007 costs for 156 individuals receiving 404 interventions. Overall, both approaches were found to produce reliable estimates of intervention costs at the group level but not at the individual level. As choice of approach can greatly impact the estimate of mean difference, adjustment based on estimation approach should be incorporated into sensitivity analyses. Analysts must take care in assessing the purpose and perspective of the analysis when choosing a costing approach for use within economic evaluation.