van den Brink Mandy, van den Hout Wilbert B, Stiggelbout Anne M, Putter Hein, van de Velde Cornelis J H, Kievit Job
Leiden University Medical Center, The Netherlands.
Int J Technol Assess Health Care. 2005 Summer;21(3):298-304. doi: 10.1017/s0266462305050397.
The feasibility and convergent validity of a cost diary and a cost questionnaire was investigated.
Data were obtained as part of a cost-utility analysis alongside a multicenter clinical trial in patients with resectable rectal cancer. A sample of 107 patients from 30 hospitals was asked to keep a weekly diary during the first 3 months after surgery, and a monthly diary from 3 to 12 months after surgery. A second sample of seventy-two patients from twenty-eight hospitals in the trial received a questionnaire at 3, 6, and 12 months after surgery, referring to the previous 3 or 6 months. Format and items of the questions were similar and included a wide range of medical and nonmedical items and costs after hospitalization for surgery.
Small differences were found with respect to nonresponse (range, 79 to 86 percent) and missing questions (range, 1 to 6 percent between the diary and questionnaire). For most estimates of volumes of care and of costs, the diary and questionnaire did not differ significantly. Total 3-month nonhospital costs were 1,860 Euros, 1,280 Euros, and 1,050 Euros in the diary sample and 1,860 Euros, 1,090 Euros, and 840 Euros in the questionnaire sample at 3, 6, and 12 months after surgery, respectively (p = .50). However, with respect to open questions, the diary sample tended to report significantly more care.
For the assessment of health-care utilization in economic evaluations alongside clinical trials, a cost questionnaire with structured closed questions may replace a cost diary for recall periods up to 6 months.
研究成本日记和成本问卷的可行性及收敛效度。
数据是作为一项成本效用分析的一部分获取的，该分析与一项针对可切除直肠癌患者的多中心临床试验同时进行。来自30家医院的107名患者样本被要求在术后前3个月每周记录日记，并在术后3至12个月每月记录日记。该试验中来自28家医院的72名患者的第二个样本在术后3、6和12个月收到一份问卷，问卷涉及前3个月或6个月的情况。问题的格式和项目相似，包括广泛的医疗和非医疗项目以及手术后住院后的费用。
在无应答（范围为79%至86%）和缺失问题（日记和问卷之间的范围为1%至6%）方面发现了细微差异。对于大多数护理量和成本的估计，日记和问卷没有显著差异。术后3、6和12个月时，日记样本中的3个月非住院总费用分别为1860欧元、1280欧元和1050欧元，问卷样本中的分别为1860欧元、1090欧元和840欧元（p = 0.50）。然而，对于开放式问题，日记样本倾向于报告更多的护理情况。
对于在临床试验同时进行的经济评估中评估医疗保健利用情况，一份带有结构化封闭式问题的成本问卷在长达6个月的回忆期内可能会取代成本日记。
