Measuring primary care expenses.

Area of Science:

• Health Services Research
• Health Economics
• Primary Care Practice Management

Background:

• Healthcare reform initiatives necessitate understanding improvement costs.
• Systematic assessment of practice expenses requires practical tools.
• A standardized expenditure data collection instrument was field-trialed.

Purpose of the Study:

• To evaluate the feasibility of a standardized instrument for collecting intervention-specific expenses in primary care.
• To identify necessary components for successful expenditure data collection.
• To assess the willingness of research networks to collect future expenditure data.

Main Methods:

• Developed an expenditure data collection instrument by combining economic and primary care practice consultation.
• Conducted feasibility testing and fielded the instrument across 10 practice-based research networks in 30 practices.
• Included practices conducting 10 different health behavior change interventions.

Main Results:

• Successfully collected start-up and operating expenses for 87% and 97% of practices, respectively.
• Data collection was considerable but acceptable; required an intervention-specific instrument, field guide, and economic oversight.
• 90% of networks planned future expenditure data collection, with participation increasing likelihood.

Conclusions:

• Systematic collection of intervention-specific expenses in primary care is feasible using formal methods.
• Most practices and researchers lack independent capacity for reliable expenditure data collection.
• Additional assistance and education are crucial for obtaining reliable cost data to improve primary care.