Emergent Challenges in Determining Costs for Economic Evaluations

Area of Science:

• Health Economics
• Healthcare Management
• Cost Analysis

Background:

• Healthcare cost determination is crucial for economic evaluations.
• Recent developments in healthcare delivery impact costing methodologies.
• Existing guidelines offer frameworks for implementing costing methods.

Purpose of the Study:

• To describe methods for determining healthcare costs.
• To analyze how recent healthcare developments affect cost determination.
• To identify strengths and weaknesses of principal costing methods.

Main Methods:

• Literature review to identify strengths and weaknesses of micro-costing, activity-based costing, charge-based costing, and gross costing.
• Scoping review to identify key healthcare delivery trends and associated costing issues.
• Analysis of six major healthcare trends impacting costing methodology.

Main Results:

• Bottom-up costing is accurate but resource-intensive; top-down approaches are often more feasible.
• Six key healthcare trends (payment reform, decentralized care, telehealth, new technology, privacy, guideline implementation) significantly affect costing.
• Certain costs (physician services, facility costs, innovation development, patient/caregiver, indirect organizational) are difficult to measure and often overlooked.

Conclusions:

• Standardized methods are needed for social welfare and productivity cost determination.
• Technological advances may aid future cost determination.
• Shift to capitated payments, less restrictive care settings, and privacy concerns may hinder future cost determination.