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The impact of using different costing methods on the results of an economic evaluation of cardiac care: microcosting vs gross‐costing approaches

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  • Fiona M. Clement (Nee Shrive)
  • William A. Ghali
  • Cam Donaldson
  • Braden J. Manns

Abstract

Background: Published guidelines on the conduct of economic evaluations provide little guidance regarding the use and potential bias of the different costing methods. Objectives: Using microcosting and two gross‐costing methods, we (1) compared the cost estimates within and across subjects, and (2) determined the impact on the results of an economic evaluation. Methods: Microcosting estimates were obtained from the local health region and gross‐costing estimates were obtained from two government bodies (one provincial and one national). Total inpatient costs were described for each method. Using an economic evaluation of sirolimus‐eluting stents, we compared the incremental cost–utility ratios that resulted from applying each method. Results: Microcosting, Case‐Mix‐Grouper (CMG) gross‐costing, and Refined‐Diagnosis‐Related grouper (rDRG) gross‐costing resulted in 4‐year mean cost estimates of $16 684, $16 232, and $10 474, respectively. Using Monte Carlo simulation, the cost per QALY gained was $41 764 (95% CI: $41 182–$42 346), $42 538 (95% CI: $42 167–$42 907), and $36 566 (95% CI: $36 172–$36 960) for microcosting, rDRG‐derived and CMG‐derived estimates, respectively (P

Suggested Citation

  • 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.
    • Handle: RePEc:wly:hlthec:v:18:y:2009:i:4:p:377-388
    DOI: 10.1002/hec.1363
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    References listed on IDEAS

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    1. Sarah Wordsworth & Anne Ludbrook & Fergus Caskey & Alison Macleod, 2005. "Collecting unit cost data in multicentre studies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 38-44, March.
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    1. 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.
    2. Richard Grieve & John Cairns & Simon G. Thompson, 2010. "Improving costing methods in multicentre economic evaluation: the use of multiple imputation for unit costs," Health Economics, John Wiley & Sons, Ltd., vol. 19(8), pages 939-954, August.
    3. Kludacz-Alessandri Magdalena, 2020. "The Relationship between Cost System Functionality, Management Accounting Practices, and Hospital Performance," Foundations of Management, Sciendo, vol. 12(1), pages 223-236, January.
    4. Grégoire Mercier & Gérald Naro, 2014. "Costing Hospital Surgery Services: The Method Matters," Post-Print hal-01829947, HAL.
    5. Letlhogonolo Makhele & Moliehi Matlala & Mncengeli Sibanda & Antony P. Martin & Brian Godman, 2019. "A Cost Analysis of Haemodialysis and Peritoneal Dialysis for the Management of End-Stage Renal Failure At an Academic Hospital in Pretoria, South Africa," PharmacoEconomics - Open, Springer, vol. 3(4), pages 631-641, December.
    6. Chrysanthos D. Christou & Eleni C. Athanasiadou & Andreas I. Tooulias & Argyrios Tzamalis & Georgios Tsoulfas, 2022. "The process of estimating the cost of surgery: Providing a practical framework for surgeons," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(4), pages 1926-1940, July.
    7. Abdelbaste Hrifach & Coralie Brault & Sandrine Couray-Targe & Lionel Badet & Pascale Guerre & Christell Ganne & Hassan Serrier & Vanessa Labeye & Pierre Farge & Cyrille Colin, 2016. "Mixed method versus full top-down microcosting for organ recovery cost assessment in a French hospital group," Health Economics Review, Springer, vol. 6(1), pages 1-7, December.
    8. Alfredo Palacios & Carlos Rojas-Roque & Lucas González & Ariel Bardach & Agustín Ciapponi & Claudia Peckaitis & Andres Pichon-Riviere & Federico Augustovski, 2021. "Direct Medical Costs, Productivity Loss Costs and Out-Of-Pocket Expenditures in Women with Breast Cancer in Latin America and the Caribbean: A Systematic Review," PharmacoEconomics, Springer, vol. 39(5), pages 485-502, May.
    9. Mareike Heimeshoff & Helge Hollmeyer & Jonas Schreyögg & Oliver Tiemann & Doris Staab, 2012. "Cost of Illness of Cystic Fibrosis in Germany," PharmacoEconomics, Springer, vol. 30(9), pages 763-777, September.
    10. 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.
    11. Claudia Fischer & Susanne Mayer & Nataša Perić & Judit Simon, 2022. "Harmonization issues in unit costing of service use for multi-country, multi-sectoral health economic evaluations: a scoping review," Health Economics Review, Springer, vol. 12(1), pages 1-13, December.

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