Economic Data Collection: Instruments for Measuring Health Service Use and Direct Health Costs – The Bottom-Up Approach

Abstract

Quality of economic data is paramount in economic evaluation. To estimate costs, it is necessary to measure consumption of resources and, in the case of direct health costs, the utilization of health services. Instruments assessing health services use rely on patient self-report, allowing bias and methodological challenges. However, the majority of health services instruments do not include mental health services. Few instruments have been developed for economic evaluation in mental health. Importantly, few instruments were validated, and in this regard, several methodological obstacles exist. The Client Sociodemographic Service Receipt Inventory is the most used instrument for estimating direct costs in economic evaluation in mental health. This chapter outlines the main methodological issues involved in developing, validating, and applying such instruments and presents the instruments available for this purpose. In this regard, an example of translating and adapting the Client Sociodemographic Service Receipt Inventory to Portuguese (ISDUCS) is described, raising the main issues related to the instrument’s feasibility and applicability in a sample with moderate and severe mental disorders in a middle-income setting.