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Validated Tools to Measure Costs for Patients: A Systematic Review



Increasing healthcare expenditures is a major concern to insurers and governments, but also to patients who must pay a greater proportion of their healthcare costs. The objective of this study was to identify validated tools for measuring the costs of a health condition for patients as well as the different elements to be considered when measuring costs from the patient’s perspective.


A systematic literature review was conducted from 1984 to December 2020. The search strategy was applied to seven different databases that had been identified prior as pertinent sources. Two authors independently extracted and compiled data. In case of disagreement, arbitration by two other researchers was conducted. The methodological quality of the included articles was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.


Among the 679 retrieved articles, nine met the inclusion criteria. The types of costs evaluated in these studies included direct costs for patients as well as for caregivers, indirect costs, and intangible costs. The development and validation processes used in these articles included a literature search, a discussion with the involved stakeholders, the development of an initial questionnaire, the testing of the questionnaire on a sample of patients, and a critical review. Regarding the psychometric properties of the tool, only five studies tested the reliability and validity of the instrument.


There are very few validated tools available to measure the different health-related costs from a patient perspective. Further research is needed to develop and validate a versatile and generalizable tool using a rigorous methodological process.

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The authors would like to thank the Quebec Support Unit of the Strategy for Patient Oriented Research (SPOR) for their financial support to conduct this study. We also thank the ÉcoSanté team for their support. TGP is a member of the FRQS-funded Centre de recherche de l’IUSMM. ML is a member of the Centre de recherche du CHU de Québec, and of Vitam, Centre de recherche en santé durable, both funded by the FRQS. TGP and ML are fellows of the FRQS.

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Correspondence to Maude Laberge.

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This study was funded by the Quebec Support Unit of the Strategy for Patient Oriented Research (SPOR).

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The authors declare that they have no conflicts of interest.

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Authors’ contributions

TGP, LPC, MG, SB, and ML conceived of and planned the review. TGP, LPC, and ML wrote the protocol. TGP and ML wrote the search terms. LPC and MG ran the searches and screened titles and abstracts. All authors reviewed full texts. LPC and MG extracted data and conducted the quality review. LPC wrote the manuscript with direction from TGP and ML. All authors were involved in revising the article and approved the final manuscript.

Role of the Funder/Sponsor

The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Poder, T.G., Coulibaly, L.P., Gaudreault, M. et al. Validated Tools to Measure Costs for Patients: A Systematic Review. Patient 15, 3–19 (2022).

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