Comparing methodologies for the cost estimation of hospital services
The aim of the study was to determine whether the total cost estimate of a hospital service remains reliable when the cost components of bottom-up microcosting were replaced by the cost components of top-down microcosting or gross costing. Total cost estimates were determined in representative general hospitals in the Netherlands for appendectomy, normal delivery, stroke and acute myocardial infarction for 2005. It was concluded that restricting the use of bottom-up microcosting to those cost components that have a great impact on the total costs (i.e., labour and inpatient stay) would likely result in reliable cost estimates.
KeywordsMicrocosting Cost comparison Cost calculation Methodology Hospital service
JEL ClassificationB40 B41 D24 D61 D70
The authors would like to thank the employees of the clinical and financial departments of the participating general hospitals who provided resource use and cost data for the cost calculations. The study was partly financed by the European Commission within the Sixth Framework Research Programme (grant no. SP21-CT-2004-501588).
- 2.Johnston, K., Buxton, M.J., Jones, D.R., Fitzpatrick, R.: Assessing the costs of healthcare technologies in clinical trials. Health Technol. Assess. 3(6), 1–76 (1999)Google Scholar
- 4.Drummond, M.F., Sculpher M.J., Torrance G.W., O’Brien B.J., Stoddart G.L.: Methods for the Economic Evaluation of Health Care Programmes, 3rd edn. Oxford University Press, New York (2005)Google Scholar
- 6.Brouwer, W., Rutten F., Koopmanschap M.: Costing in Economic Evaluations. Economic Evaluation in Healthcare: Merging Theory with Practice. Oxford University Press, New York (2001)Google Scholar
- 12.Centraal Bureau voor de Statistiek, Ministerie voor Volksgezondheid Welzijn en Sport. Vademecum gezondheidsstatistiek Nederland 2003, 1st ed. Den Haag: SDU (2004)Google Scholar
- 13.Gold, M.E., Siegel, J.E., Russell, L.B., Weinstein, M.C.: Cost-Effectiveness in Health and Medicine. Oxford University Press, New York (1996)Google Scholar