Process evaluation of health system costing - Experience from CHSI study in India.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
15
10
2019
accepted:
23
04
2020
entrez:
14
5
2020
pubmed:
14
5
2020
medline:
31
7
2020
Statut:
epublish
Résumé
A national study, 'Costing of healthcare services in India' (CHSI) aimed at generating reliable healthcare cost estimates for health technology assessment and price-setting is being undertaken in India. CHSI sampled 52 public and 40 private hospitals in 13 states and used a mixed micro-costing approach. This paper aims to outline the process, challenges and critical lessons of cost data collection to feed methodological and quality improvement of data collection. An exploratory survey with 3 components-an online semi-structured questionnaire, group discussion and review of monitoring data, was conducted amongst CHSI data collection teams. There were qualitative and quantitative components. Difficulty in obtaining individual data was rated on a Likert scale. Mean time taken to complete cost data collection in one department/speciality was 7.86(±0.51) months, majority of which was spent on data entry and data issues resolution. Data collection was most difficult for determination of equipment usage (mean difficulty score 6.59±0.52), consumables prices (6.09±0.58), equipment price(6.05±0.72), and furniture price(5.64±0.68). Human resources, drugs & consumables contributed to 78% of total cost and 31% of data collection time. However, furniture, overheads and equipment consumed 51% of time contributing only 9% of total cost. Seeking multiple permissions, absence of electronic records, multiple sources of data were key challenges causing delays. Micro-costing is time and resource intensive. Addressing key issues prior to data collection would ease the process of data collection, improve quality of estimates and aid priority setting. Electronic health records and availability of national cost data base would facilitate conducting costing studies.
Sections du résumé
BACKGROUND
A national study, 'Costing of healthcare services in India' (CHSI) aimed at generating reliable healthcare cost estimates for health technology assessment and price-setting is being undertaken in India. CHSI sampled 52 public and 40 private hospitals in 13 states and used a mixed micro-costing approach. This paper aims to outline the process, challenges and critical lessons of cost data collection to feed methodological and quality improvement of data collection.
METHODS
An exploratory survey with 3 components-an online semi-structured questionnaire, group discussion and review of monitoring data, was conducted amongst CHSI data collection teams. There were qualitative and quantitative components. Difficulty in obtaining individual data was rated on a Likert scale.
RESULTS
Mean time taken to complete cost data collection in one department/speciality was 7.86(±0.51) months, majority of which was spent on data entry and data issues resolution. Data collection was most difficult for determination of equipment usage (mean difficulty score 6.59±0.52), consumables prices (6.09±0.58), equipment price(6.05±0.72), and furniture price(5.64±0.68). Human resources, drugs & consumables contributed to 78% of total cost and 31% of data collection time. However, furniture, overheads and equipment consumed 51% of time contributing only 9% of total cost. Seeking multiple permissions, absence of electronic records, multiple sources of data were key challenges causing delays.
CONCLUSIONS
Micro-costing is time and resource intensive. Addressing key issues prior to data collection would ease the process of data collection, improve quality of estimates and aid priority setting. Electronic health records and availability of national cost data base would facilitate conducting costing studies.
Identifiants
pubmed: 32401763
doi: 10.1371/journal.pone.0232873
pii: PONE-D-19-28752
pmc: PMC7219765
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0232873Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
PLoS One. 2013 Jul 23;8(7):e69728
pubmed: 23936088
PLoS One. 2018 Jan 11;13(1):e0191132
pubmed: 29324861
J Clin Diagn Res. 2015 Nov;9(11):FC09-12
pubmed: 26675983
Appl Health Econ Health Policy. 2015 Dec;13(6):595-613
pubmed: 26449485
Pharmacoecon Open. 2019 Sep;3(3):391-402
pubmed: 30783991
BMC Pregnancy Childbirth. 2018 Oct 3;18(1):390
pubmed: 30285669
Appl Health Econ Health Policy. 2017 Oct;15(5):681-692
pubmed: 28409489
Indian J Hematol Blood Transfus. 2018 Jan;34(1):25-31
pubmed: 29398796
Clin Kidney J. 2018 Oct;11(5):726-733
pubmed: 30288270
Trans R Soc Trop Med Hyg. 2019 Nov 1;113(11):661-669
pubmed: 31294808
Pharmacoecon Open. 2018 Mar;2(1):1-3
pubmed: 29464668
Indian J Nucl Med. 2014 Oct;29(4):241-5
pubmed: 25400363
Int J STD AIDS. 2019 Jul;30(8):769-778
pubmed: 31081489
Indian J Nucl Med. 2017 Jan-Mar;32(1):1-6
pubmed: 28242974
Indian Pediatr. 2013 Sep;50(9):839-46
pubmed: 23502671
Indian J Crit Care Med. 2016 Jul;20(7):398-403
pubmed: 27555693
Indian J Med Res. 2017 Sep;146(3):354-361
pubmed: 29355142
PLoS One. 2016 Aug 18;11(8):e0160986
pubmed: 27536781
BMJ Open. 2013 Jun 20;3(6):
pubmed: 23794591
J Trop Pediatr. 2013 Dec;59(6):489-95
pubmed: 23872793
Indian J Med Res. 2018 Sep;148(3):258-261
pubmed: 30425215
World J Surg. 2016 May;40(5):1034-40
pubmed: 26675929
Pharmacoecon Open. 2018 Jun;2(2):179-190
pubmed: 29623618
Indian J Community Med. 2019 Apr-Jun;44(2):147-151
pubmed: 31333294
Glob Health Action. 2014 Feb 18;7:23257
pubmed: 24565214
BMC Health Serv Res. 2005 Nov 05;5:69
pubmed: 16271151
Health Econ. 2016 Feb;25 Suppl 1:29-41
pubmed: 26775571
PLoS One. 2014 Mar 13;9(3):e91781
pubmed: 24626285