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Micro-costing in health and medicine: a critical appraisal

Author

Listed:
  • Xiao Xu

    (Yale School of Medicine)

  • Christina M. Lazar

    (Yale School of Medicine)

  • Jennifer Prah Ruger

    (Perelman School of Medicine, The Leonard Davis Institute of Health Economics, School of Social Policy & Practice, University of Pennsylvania)

Abstract

Background Concerns about rising health care costs require rigorous economic study to inform clinical and policy decision-making. Micro-costing is a cost estimation methodology employing detailed resource utilization and unit cost data to generate precise estimates of economic costs. Micro-costing studies have not been critically appraised. Methods Critical appraisal of micro-costing studies in English. Studies fully or predominantly employing micro-costing were appraised for methodological and reporting quality through economic evaluation guidelines (Evers, Drummond, Consolidated Health Economic Evaluation Reporting Standards (CHEERS), Fukuda and Imanaka checklists). Following the Panel on Cost Effectiveness in Health and Medicine, micro-costing studies were defined as involving “direct enumeration and costing out of every input consumed in the treatment of a particular patient.” Results Full or predominant micro-costing studies included neoplasms (18.5%), infectious and parasitic diseases (17.9%), and diseases of circulatory systems (10.8%) as the most studied diseases. 36.9% were in the United States and 34.9% were in Europe. 33.8% did not report analytic perspective, 32.8% did not report price year, 3.6% did not inflation adjust cost data, and 44.1% did not specify inflation adjustment. 86.2% did not separately report unit costs and resource utilization quantity, 14.9 and 19.5% did not provide sufficient detail to assess appropriateness of measured physical units or valued costs. Conclusions Micro-costing studies vary widely in methodological and reporting quality, highlighting the need to standardize methods and reporting of micro-costing studies and develop tools for their evaluation.

Suggested Citation

  • 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.
    • Handle: RePEc:spr:hecrev:v:11:y:2021:i:1:d:10.1186_s13561-020-00298-5
    DOI: 10.1186/s13561-020-00298-5
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    References listed on IDEAS

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    1. Fiona M. Clement (Nee Shrive) & William A. Ghali & Cam Donaldson & Braden J. Manns, 2009. "The impact of using different costing methods on the results of an economic evaluation of cardiac care: microcosting vs gross‐costing approaches," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 377-388, April.
    2. Grégoire Mercier & Gérald Naro, 2014. "Costing Hospital Surgery Services: The Method Matters," Post-Print hal-01829947, HAL.
    3. 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.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 8th March 2021
      by Chris Sampson in The Academic Health Economists' Blog on 2021-03-08 12:00:01

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