Collecting unit cost data in multicentre studies. Creating comparable methods.
Collecting unit cost data in multicentre studies. Creating comparable methods.
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DOI：
10.1007/s10198-004-0259-9
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发表时间：
2005-03-01
期刊：
影响因子：
--
通讯作者：
Macleod, Alison
中科院分区：
文献类型：
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作者：
Wordsworth, Sarah;Ludbrook, Anne;Macleod, Alison
卫生保健系统和服务的国际比较引起了人们对成本结果可比性的更大兴趣。这项研究在检查全欧洲透析治疗的成本效益的背景下，比较了自上而下和自下而上收集跨中心单位成本数据的方法。这项研究测试了是否可以使用一致和透明的方法来计算不同国家的卫生保健技术的成本，以增加结果的可比性。腹膜透析的方法比血液透析的方法更一致，差异分别为91-1,687欧元和333-7,314欧元/年。血液透析结果显示，当透析单元被整合为较大医院的一部分时，差异最大。决定采用哪种方法在很大程度上取决于技术。然而，对于人员投入或管理费用占很大比例、技术或患者群体之间大量共享人员或设施的技术，以及不定期将成本分配到干预水平的卫生保健成本计算系统，应考虑自下而上的成本计算。在这种情况下，这种成本计算方法可以提高一致性和透明度，从而提高成本结果的可比性。
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 Euro 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.