Methodologic principles of cost analyses in the nursing, medical, and health services literature, 1990-1996.

BACKGROUND: Cost analyses are needed to inform resource decisions. Oftentimes, however cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), cost-minimization analysis (CMA), and cost-utility analysis (CUA) are performed using untested techniques and adhering to a variety of questionable p...

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Publicado en:Nursing Research Vol. 48; no. 2; pp. 94 - 105
Autores principales: Chang W, Henry BM
Formato: forms review tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins 1999 Mar-Apr
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 1999 Mar-Apr
      vid: 48
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Methodologic principles of cost analyses in the nursing, medical, and health services literature, 1990-1996.
      aug:
        au:
          Chang W
          Henry BM
        affil: College of Nursing, University of Illinois at Chicago, MC 802, 845 S Damen Ave, Chicago, IL 60612-7350
      sug:
        subj:
          Costs and Cost Analysis
          Checklists
          Nursing Literature
          Medical Literature
          Allied Health Literature
          Cost Benefit Analysis
          Reference Databases, Health
          Costs and Cost Analysis Methods
      ab: BACKGROUND: Cost analyses are needed to inform resource decisions. Oftentimes, however cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), cost-minimization analysis (CMA), and cost-utility analysis (CUA) are performed using untested techniques and adhering to a variety of questionable principles. OBJECTIVES: To analyze, compare, and present a set of useful principles for the main types and methods of cost analyses through a synthesis of current information in the published literature. METHODS: The area of interest included all reports of cost research published as full articles in professional journals from January 1990 to August 1996 in the nursing, medical, and health services fields. In all, 88 sampled articles met the criteria for inclusion. A four-page data collection guide with 28 items grouped as demographics, cost-analysis types, methods, and principles was designed for the review. Incremental testing for interrater reliability using the kappa statistic for two raters was performed. Sampling, process-oriented, construct, and correlational validity were assessed. RESULTS: The 88 articles included 4 from nursing, 59 from medical, and 25 from health services journals. Of these articles, 45 (51%) reported CBA, 36 (41%) CEA, 2 CMA, 4 CUA, and 1 both CBA and CEA. Three nursing studies were authored only by nurses. Three fourths of the medical and four fifths of the health services publications had interdisciplinary authorship. Existing databases were the primary source of data in 61 (69%) publications. Adherence to six main methodologic principles was apparent in 19 (22%) articles. None of the nursing studies adhered to all six principles, whereas 16% of the health services and 25% of the medical studies did. CONCLUSIONS: Funded cost analyses of nursing interventions that adhere to the six known methodologic principles are needed to inform policy-level health care decisions. Because of the complexity of cost analysis methodology, including sensitivity analysis, future interdisciplinary efforts using existing databases may prove most effective. The six methodologic principles presented in this article can be useful for future nursing education and cost-analysis research designed to control cost and increase the quality of health care.
      pubtype: Academic Journal
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        review
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      ougenre: Article
    language: English
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