Abstract
BackgroundAn economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia however. This systematic review therefore aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia.MethodA comprehensive search of Medline, Embase, CINAHL, Google Scholar and Google was undertaken. Specialised economic databases were also reviewed. In addition Australian Government Department websites were inspected. The search identified the cost of specified allied health services including: physiotherapy, occupational therapy, dietetics, podiatry, counselling and home nursing. The range of community services included: personal care, meals on wheels, transport costs and domestic services. Where the information was not available, direct contact with service providers was made.ResultsThe number of eligible studies included in the qualitative synthesis was fourty-nine. Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72.ConclusionsUtilisation of the Medicare Benefits Scheduled fee as a broad indicator of the costs of services, may lead to underestimation of the real costs of services and therefore to inaccuracies in economic evaluation.
Highlights
An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services
Calculated hourly rates for Australian allied health services were adjusted to be in equivalent currency and were as follows as follows: physiotherapy $157.75, occupational therapy $150.77, dietetics $163.11, psychological services $165.77, community nursing $105.76 and podiatry $129.72
The difficulty in the use of available data is that reliance on established fee schedules, for example, the Medicare Benefits Schedule in Australia [5] may not provide an accurate indication of the real cost of providing services in some clinical areas [6]; this may result in serious underestimation of the actual costs of service delivery [7]
Summary
An economic evaluation of interventions for older people requires accurate assessment of costing and consideration of both acute and long-term services. Accurate information on the unit cost of allied health and community services is not readily available in Australia . This systematic review aims to synthesise information available in the literature on the unit costs of allied health and community services that may be utilised by an older person living in Australia. A fundamental requirement for economic evaluation is accurate assessment of costing [1,2] This allows comparative analysis of the impact of an intervention program on the costs of service utilisation and the accrued cost to benefit ratio [2]. To fully appreciate the cost of age-related disease and the cost effectiveness of healthcare programs, information on the cost of the full range of services utilised (including allied health and community services) is required
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