Abstract
BackgroundEconomic evaluations that include the patient perspective often base their estimates of patient time and travel costs on data collected at a single point in time. This, however, may be inaccurate if the costs of accessing care change substantially over time, as may be the case for young people in transition from paediatric to adult health services.AimsThe aim of this study was to explore the differences in these time and travel costs between two data collection points for young individuals in transition between health care services, and thus to provide an insight of whether such costs should be collected more than once.MethodsDescriptive statistics and regression modelling were used to estimate the average difference in costs between the two points of data collection, as well as the potential drivers of those cost differences.ResultsWe found a small difference in costs between the two time points, equal to -£45.78 [95% CI: − 89.70 to − 1.86]. The results were largely driven by changes in the unit cost of visits and in the number of attendances.ConclusionsA simple and common assumption that patient costs could be collected at a single time point cannot be made in the context of our study. When deciding on the frequency of elicitation of patient costs, future studies should consider the relative impacts of additional data collection on the estimates of efficiency, inequalities and resource implications for collecting new data.
Highlights
Economic evaluations can take a variety of different perspectives about whose costs and benefits are important to consider
As the approaches adopted by National Institute for Care and Excellence (NICE) and Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) illustrate, a key Simpson et al BMC Health Services Research (2021) 21:263 requirement for any health technology assessment is that studies including an economic evaluation state the perspective from which costs and benefits are considered and how these will be collected [4]
We used regression modelling to estimate the association between the total time and travel costs (C) and a dummy variable for the time point 2 (TP), whilst controlling for a vector (X) of other characteristics predicted to be related to time and travel cost, including speciality, the type of service, age, gender and deprivation
Summary
Economic evaluations can take a variety of different perspectives about whose costs and benefits are important to consider. In Germany the independent Institute for Quality and Efficiency in Health Care (Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, IQWiG) takes the perspective of the statutory health insurance. With this perspective, costs borne by those covered by the insurance should be considered. As the approaches adopted by NICE and IQWiG (and other health technology assessment agencies worldwide) illustrate, a key Simpson et al BMC Health Services Research (2021) 21:263 requirement for any health technology assessment is that studies including an economic evaluation state the perspective from which costs and benefits are considered and how these will be collected [4]. This, may be inaccurate if the costs of accessing care change substantially over time, as may be the case for young people in transition from paediatric to adult health services
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