The use of micro-costing in economic analyses of surgical interventions: a systematic review

Shelley Potter, Charlotte Davies (), Gareth Davies, Caoimhe Rice and William Hollingworth
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Shelley Potter: Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School
Charlotte Davies: Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School
Gareth Davies: Bristol Centre for Surgical Research, Population Health Sciences, Bristol Medical School
Caoimhe Rice: Population Health Sciences, Bristol Medical School, University Of Bristol
William Hollingworth: Population Health Sciences, Bristol Medical School, University Of Bristol

Health Economics Review, 2020, vol. 10, issue 1, 1-11

Abstract: Abstract Background Compared with conventional top down costing, micro-costing may provide a more accurate method of resource-use assessment in economic analyses of surgical interventions, but little is known about its current use. The aim of this study was to systematically-review the use of micro-costing in surgery. Methods Comprehensive searches identified complete papers, published in English reporting micro-costing of surgical interventions up to and including 22nd June 2018. Studies were critically appraised using a modified version of the Consensus on Health Economic Criteria (CHEC) Checklist. Study demographics and details of resources identified; methods for measuring and valuing identified resources and any cost-drivers identified in each study were summarised. Results A total of 85 papers were identified. Included studies were mainly observational comparative studies (n = 42, 49.4%) with few conducted in the context of a randomised trial (n = 5, 5.9%). The majority of studies were single-centre (n = 66, 77.6%) and almost half (n = 40, 47.1%) collected data retrospectively. Only half (n = 46, 54.1%) self-identified as being ‘micro-costing’ studies. Rationale for the use of micro-costing was most commonly to compare procedures/techniques/processes but over a third were conducted specifically to accurately assess costs and/or identify cost-drivers. The most commonly included resources were personnel costs (n = 76, 89.4%); materials/disposables (n = 76, 89.4%) and operating-room costs (n = 62,72.9%). No single resource was included in all studies. Most studies (n = 72, 84.7%) identified key cost-drivers for their interventions. Conclusions There is lack of consistency regarding the current use of micro-costing in surgery. Standardising terminology and focusing on identifying and accurately costing key cost-drivers may improve the quality and value of micro-costing in future studies. Trial registration PROSPERO registration CRD42018099604.

Keywords: Micro-costing; Economic evaluation; Surgery; Systematic review (search for similar items in EconPapers)
Date: 2020
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DOI: 10.1186/s13561-020-0260-8

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