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Comparison of hospital costing methods in an economic evaluation of a multinational clinical trial.

Publication ,  Journal Article
Reed, SD; Friedman, JY; Gnanasakthy, A; Schulman, KA
Published in: Int J Technol Assess Health Care
2003

OBJECTIVES: To develop and evaluate strategies for estimating hospitalization costs in multinational clinical trials. METHODS: Hospital cost estimates for eleven diagnoses were collected from twelve countries participating in a trial of therapies for congestive heart failure. Estimates were combined with U.S.-based diagnosis-related group weights to compute country-specific unit cost estimates for all reasons for hospitalization. Variations of hospital costing methods were developed. The unit cost method assigns a country-specific unit cost estimate to each hospitalization. The other methods adjust for length of stay using a daily cost (DC) estimate for each diagnosis, based on either the mean length of stay (DC-mean method) or the median length of stay (DC-median method) for each diagnosis in each country. Additional modifications were explored through adjustment of the distribution of daily costs incurred during a hospital stay. RESULTS: The mean cost for all hospitalizations was dollars 10,242 (SD, 10,042) using the unit cost method, dollars 10,242 (SD, 12,760) using the standard DC-mean method, and dollars 13,967 (SD, 18,762) using the standard DC-median method. In comparisons of costs for all 5,486 hospitalizations incurred by a subset of 2,352 patients in the trial, the unit cost method provided 92% power to detect a dollars 1,000 cost difference. The standard DC-mean method provided 76% power, and the standard DC-median method provided 44% power. CONCLUSIONS: Hospital costing methods that adjust for differences in length of stay require a significantly larger sample to attain comparable statistical power as methods that assign unadjusted unit cost estimates to hospitalization events.

Duke Scholars

Published In

Int J Technol Assess Health Care

DOI

ISSN

0266-4623

Publication Date

2003

Volume

19

Issue

2

Start / End Page

396 / 406

Location

England

Related Subject Headings

  • United States
  • Length of Stay
  • Internationality
  • Humans
  • Hospitalization
  • Hospital Costs
  • Heart Failure
  • Health Policy & Services
  • Diagnosis-Related Groups
  • Developed Countries
 

Citation

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Reed, S. D., Friedman, J. Y., Gnanasakthy, A., & Schulman, K. A. (2003). Comparison of hospital costing methods in an economic evaluation of a multinational clinical trial. Int J Technol Assess Health Care, 19(2), 396–406. https://doi.org/10.1017/s0266462303000357
Reed, Shelby D., Joëlle Y. Friedman, Ari Gnanasakthy, and Kevin A. Schulman. “Comparison of hospital costing methods in an economic evaluation of a multinational clinical trial.Int J Technol Assess Health Care 19, no. 2 (2003): 396–406. https://doi.org/10.1017/s0266462303000357.
Reed SD, Friedman JY, Gnanasakthy A, Schulman KA. Comparison of hospital costing methods in an economic evaluation of a multinational clinical trial. Int J Technol Assess Health Care. 2003;19(2):396–406.
Reed, Shelby D., et al. “Comparison of hospital costing methods in an economic evaluation of a multinational clinical trial.Int J Technol Assess Health Care, vol. 19, no. 2, 2003, pp. 396–406. Pubmed, doi:10.1017/s0266462303000357.
Reed SD, Friedman JY, Gnanasakthy A, Schulman KA. Comparison of hospital costing methods in an economic evaluation of a multinational clinical trial. Int J Technol Assess Health Care. 2003;19(2):396–406.
Journal cover image

Published In

Int J Technol Assess Health Care

DOI

ISSN

0266-4623

Publication Date

2003

Volume

19

Issue

2

Start / End Page

396 / 406

Location

England

Related Subject Headings

  • United States
  • Length of Stay
  • Internationality
  • Humans
  • Hospitalization
  • Hospital Costs
  • Heart Failure
  • Health Policy & Services
  • Diagnosis-Related Groups
  • Developed Countries