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Costing Hospital Surgery Services: The Method Matters

Author

Listed:
  • Grégoire Mercier

    (ITI - Département Image et Traitement Information - UEB - Université européenne de Bretagne - European University of Brittany - Télécom Bretagne - IMT - Institut Mines-Télécom [Paris])

  • Gérald Naro

    (MRM - Montpellier Research in Management - UM1 - Université Montpellier 1 - UPVM - Université Paul-Valéry - Montpellier 3 - UM2 - Université Montpellier 2 - Sciences et Techniques - UPVD - Université de Perpignan Via Domitia - Groupe Sup de Co Montpellier (GSCM) - Montpellier Business School)

Abstract

Background Accurate hospital costs are required for policy-makers, hospital managers and clinicians to improve efficiency and transparency. However, different methods are used to allocate direct costs, and their agreement is poorly understood. The aim of this study was to assess the agreement between bottom-up and top-down unit costs of a large sample of surgical operations in a French tertiary centre. Methods Two thousand one hundred and thirty consecutive procedures performed between January and October 2010 were analysed. Top-down costs were based on pre-determined weights, while bottom-up costs were calculated through an activity-based costing (ABC) model. The agreement was assessed using correlation coefficients and the Bland and Altman method. Variables associated with the difference between methods were identified with bivariate and multivariate linear regressions. Results The correlation coefficient amounted to 0.73 (95%CI: 0.72; 0.76). The overall agreement between methods was poor. In a multivariate analysis, the cost difference was independently associated with age (Beta = −2.4; p = 0.02), ASA score (Beta = 76.3; p

Suggested Citation

  • Grégoire Mercier & Gérald Naro, 2014. "Costing Hospital Surgery Services: The Method Matters," Post-Print hal-01829947, HAL.
    • Handle: RePEc:hal:journl:hal-01829947
    DOI: 10.1371/journal.pone.0097290
    Note: View the original document on HAL open archive server: https://hal.umontpellier.fr/hal-01829947v1
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    Cited by:

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    2. Lucy Cunnama & Edina Sinanovic & Lebogang Ramma & Nicola Foster & Leigh Berrie & Wendy Stevens & Sebaka Molapo & Puleng Marokane & Kerrigan McCarthy & Gavin Churchyard & Anna Vassall, 2016. "Using Top‐down and Bottom‐up Costing Approaches in LMICs: The Case for Using Both to Assess the Incremental Costs of New Technologies at Scale," Health Economics, John Wiley & Sons, Ltd., vol. 25(S1), pages 53-66, February.
    3. Sandra Sülz & Holger Wagenaar & Joris van de Klundert, 2021. "Have Dutch Hospitals Saved Lives and Reduced Costs? A longitudinal patient‐level analysis over the years 2013–2017," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2399-2408, September.
    4. Adam D M Briggs & Peter Scarborough & Jane Wolstenholme, 2018. "Estimating comparable English healthcare costs for multiple diseases and unrelated future costs for use in health and public health economic modelling," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-14, May.
    5. 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.
    6. Eva Glaeser & Bart Jacobs & Bernd Appelt & Elias Engelking & Ir Por & Kunthea Yem & Steffen Flessa, 2020. "Costing of Cesarean Sections in a Government and a Non-Governmental Hospital in Cambodia—A Prerequisite for Efficient and Fair Comprehensive Obstetric Care," IJERPH, MDPI, vol. 17(21), pages 1-15, November.

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