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Costing Hospital Surgery Services: The Method Matters

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  • Gregoire Mercier
  • Gerald Naro

Abstract

Background: Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre. Methods: Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC) model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions. Results: The correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76). The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = −2.4; p = 0.02), ASA score (Beta = 76.3; p

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  • Gregoire Mercier & Gerald Naro, 2014. "Costing Hospital Surgery Services: The Method Matters," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-7, May.
    • Handle: RePEc:plo:pone00:0097290
    DOI: 10.1371/journal.pone.0097290
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    2. Sandra Sülz & Holger Wagenaar & Joris van de Klundert, 2021. "Have Dutch Hospitals Saved Lives and Reduced Costs? A longitudinal patient‐level analysis over the years 2013–2017," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2399-2408, September.
    3. Adam D M Briggs & Peter Scarborough & Jane Wolstenholme, 2018. "Estimating comparable English healthcare costs for multiple diseases and unrelated future costs for use in health and public health economic modelling," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-14, May.
    4. Eva Glaeser & Bart Jacobs & Bernd Appelt & Elias Engelking & Ir Por & Kunthea Yem & Steffen Flessa, 2020. "Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care," IJERPH, MDPI, vol. 17(21), pages 1-15, November.
    5. Xiao Xu & Christina M. Lazar & Jennifer Prah Ruger, 2021. "Micro-costing in health and medicine: a critical appraisal," Health Economics Review, Springer, vol. 11(1), pages 1-8, December.
    6. Zuzana Špacírová & David Epstein & Leticia García-Mochón & Joan Rovira & Antonio Olry de Labry Lima & Jaime Espín, 2020. "A general framework for classifying costing methods for economic evaluation of health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 529-542, June.
    7. Siti Norain Azahar & Saperi Sulong & Wan Asyraf Wan Zaidi & Norliza Muhammad & Yusof Kamisah & Norliana Masbah, 2022. "Direct Medical Cost of Stroke and the Cost-Effectiveness of Direct Oral Anticoagulants in Atrial Fibrillation-Related Stroke: A Cross-Sectional Study," IJERPH, MDPI, vol. 19(3), pages 1-17, January.

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