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Process evaluation of health system costing – Experience from CHSI study in India

Author

Listed:
  • Shankar Prinja
  • Sehr Brar
  • Maninder Pal Singh
  • Kavitha Rajsekhar
  • Oshima Sachin
  • Jyotsna Naik
  • Malkeet Singh
  • Himanshi Tomar
  • CHSI Study Collaborating Investigators
  • Pankaj Bahuguna
  • Lorna Guinness

Abstract

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.

Suggested Citation

  • Shankar Prinja & Sehr Brar & Maninder Pal Singh & Kavitha Rajsekhar & Oshima Sachin & Jyotsna Naik & Malkeet Singh & Himanshi Tomar & CHSI Study Collaborating Investigators & Pankaj Bahuguna & Lorna G, 2020. "Process evaluation of health system costing – Experience from CHSI study in India," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-22, May.
    • Handle: RePEc:plo:pone00:0232873
    DOI: 10.1371/journal.pone.0232873
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    References listed on IDEAS

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    1. Shankar Prinja & Pankaj Bahuguna & Ajay Duseja & Manmeet Kaur & Yogesh Kumar Chawla, 2018. "Cost of Intensive Care Treatment for Liver Disorders at Tertiary Care Level in India," PharmacoEconomics - Open, Springer, vol. 2(2), pages 179-190, June.
    2. Shankar Prinja & Laura E. Downey & Vijay K. Gauba & Soumya Swaminathan, 2018. "Health Technology Assessment for Policy Making in India: Current Scenario and Way Forward," PharmacoEconomics - Open, Springer, vol. 2(1), pages 1-3, March.
    3. Shankar Prinja & Gursimer Jeet & Ramesh Verma & Dinesh Kumar & Pankaj Bahuguna & Manmeet Kaur & Rajesh Kumar, 2014. "Economic Analysis of Delivering Primary Health Care Services through Community Health Workers in 3 North Indian States," PLOS ONE, Public Library of Science, vol. 9(3), pages 1-9, March.
    4. Susmita Chatterjee & Carol Levin & Ramanan Laxminarayan, 2013. "Unit Cost of Medical Services at Different Hospitals in India," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.
    5. Akashdeep Singh Chauhan & Shankar Prinja & Sushmita Ghoshal & Roshan Verma & Arun S Oinam, 2018. "Cost of treatment for head and neck cancer in India," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-13, January.
    6. Shankar Prinja & Akashdeep Chauhan & Blake Angell & Indrani Gupta & Stephen Jan, 2015. "A Systematic Review of the State of Economic Evaluation for Health Care in India," Applied Health Economics and Health Policy, Springer, vol. 13(6), pages 595-613, December.
    7. Ankur Sangwan & Shankar Prinja & Sameer Aggarwal & Jagnoor Jagnoor & Pankaj Bahuguna & Rebecca Ivers, 2017. "Cost of Trauma Care in Secondary- and Tertiary-Care Public Sector Hospitals in North India," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 681-692, October.
    8. Shankar Prinja & Yashpaul Sharma & Jyoti Dixit & Shyam Kumar Singh Thingnam & Rajesh Kumar, 2019. "Cost of Treatment of Valvular Heart Disease at a Tertiary Hospital in North India: Policy Implications," PharmacoEconomics - Open, Springer, vol. 3(3), pages 391-402, September.
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