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Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM


  • Irina Pokhilenko

    (Maastricht University
    University of Birmingham)

  • Luca M. M. Janssen

    (Maastricht University)

  • Aggie T. G. Paulus

    (Maastricht University
    Maastricht University)

  • Ruben M. W. A. Drost

    (Maastricht University)

  • William Hollingworth

    (University of Bristol)

  • Joanna C. Thorn

    (University of Bristol)

  • Sian Noble

    (University of Bristol)

  • Judit Simon

    (Medical University of Vienna
    University of Oxford)

  • Claudia Fischer

    (Medical University of Vienna)

  • Susanne Mayer

    (Medical University of Vienna)

  • Luis Salvador-Carulla

    (University of Canberra
    University of Sydney)

  • Alexander Konnopka

    (University Medical Center Hamburg)

  • Leona Hakkaart van Roijen

    (Erasmus University of Rotterdam)

  • Valentin Brodszky

    (Corvinus University of Budapest)

  • A-La Park

    (London School of Economics and Political Science)

  • Silvia M. A. A. Evers

    (Maastricht University
    Trimbos Institute National Institute of Mental Health and Addiction)


Background Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than methodological evidence. Furthermore, few resource-use measurement (RUM) instruments focus on the measurement of resource use in multiple societal sectors and their development process is rarely described. Thorn and colleagues proposed a stepwise approach to the development of RUM instruments, which has been used for developing cost questionnaires for specific trials. However, it remains unclear how this approach can be translated into practice and whether it is applicable to the development of generic self-reported RUM instruments and instruments measuring resource use in multiple sectors. This study provides a detailed description of the practical application of this stepwise approach to the development of a multi-sectoral RUM instrument developed within the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) project. Methods For the development of the PECUNIA RUM, the methodological approach was based on best practice guidelines. The process included six steps, including the definition of the instrument attributes, identification of cost-driving elements in each sector, review of methodological literature and development of a harmonized cross-sectorial approach, development of questionnaire modules and their subsequent harmonization. Results The selected development approach was, overall, applicable to the development of the PECUNIA RUM. However, due to the complexity of the development of a multi-sectoral RUM instrument, additional steps such as establishing a uniform methodological basis, harmonization of questionnaire modules and involvement of a broader range of stakeholders (healthcare professionals, sector-specific experts, health economists) were needed. Conclusion This is the first study that transparently describes the development process of a generic multi-sectoral RUM instrument in health economics and provides insights into the methodological aspects and overall validity of its development process.

Suggested Citation

  • Irina Pokhilenko & Luca M. M. Janssen & Aggie T. G. Paulus & Ruben M. W. A. Drost & William Hollingworth & Joanna C. Thorn & Sian Noble & Judit Simon & Claudia Fischer & Susanne Mayer & Luis Salvador-, 2023. "Development of an Instrument for the Assessment of Health-Related Multi-sectoral Resource Use in Europe: The PECUNIA RUM," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 155-166, March.
  • Handle: RePEc:spr:aphecp:v:21:y:2023:i:2:d:10.1007_s40258-022-00780-7
    DOI: 10.1007/s40258-022-00780-7

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    References listed on IDEAS

    1. Severens, Johan L. & Mulder, Jan & Laheij, Robert J. F. & Verbeek, André L. M., 2000. "Precision and accuracy in measuring absence from work as a basis for calculating productivity costs in The Netherlands," Social Science & Medicine, Elsevier, vol. 51(2), pages 243-249, July.
    2. Joanna Thorn & Joanna Coast & David Cohen & William Hollingworth & Martin Knapp & Sian Noble & Colin Ridyard & Sarah Wordsworth & Dyfrig Hughes, 2013. "Resource-Use Measurement Based on Patient Recall: Issues and Challenges for Economic Evaluation," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 155-161, June.
    3. Drummond, Michael F. & Sculpher, Mark J. & Claxton, Karl & Stoddart, Greg L. & Torrance, George W., 2015. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 4, number 9780199665884.
    4. Sarah Byford & Morven Leese & Martin Knapp & Helen Seivewright & Susan Cameron & Vanessa Jones & Kate Davidson & Peter Tyrer, 2007. "Comparison of alternative methods of collection of service use data for the economic evaluation of health care interventions," Health Economics, John Wiley & Sons, Ltd., vol. 16(5), pages 531-536, May.
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