Guerriere Denise N, Ungar Wendy J, Corey Mary, Croxford Ruth, Tranmer Jennifer E, Tullis Elizabeth, Coyte Peter C
Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario M5T 3M6, Canada.
Int J Technol Assess Health Care. 2006 Spring;22(2):203-10. doi: 10.1017/S0266462306051026.
Although measuring the utilization of ambulatory and home-based healthcare resources is an essential component of economic analyses, very little methodological attention has been devoted to the development and evaluation of resource costing tools. This study evaluated a newly developed tool, the Ambulatory and Home Care Record (AHCR), which comprehensively evaluates costs incurred by the health system and care recipients and their unpaid caregivers.
The level of agreement between self-reports from 110 cystic fibrosis care recipients and administrative data was assessed for four categories of health services: home-based visits with healthcare professionals, ambulatory visits with healthcare professionals, laboratory and diagnostic tests, and prescription medications.
Agreement between care recipients' reports on the AHCR and administrative data ranged from moderate (kappa = 0.41; 95 percent confidence interval, 0.16-0.61) for physician specialist visits to perfect (kappa = 1.0) for physiotherapy visits.
By evaluating and standardizing a resource and costing tool, such as the AHCR, economic evaluations may be improved and comparisons of the resource implications for different services and for diverse populations are possible.
尽管衡量门诊和居家医疗资源的利用情况是经济分析的重要组成部分，但在资源成本核算工具的开发和评估方面，方法学上的关注却很少。本研究评估了一种新开发的工具——门诊和家庭护理记录（AHCR），该工具全面评估了卫生系统、护理接受者及其无偿护理人员产生的成本。
针对四类医疗服务，评估了110名囊性纤维化护理接受者的自我报告与行政数据之间的一致性：与医疗专业人员的居家访视、与医疗专业人员的门诊访视、实验室和诊断测试以及处方药。
护理接受者在AHCR上的报告与行政数据之间的一致性，从医生专科门诊的中等一致性（kappa = 0.41；95%置信区间，0.16 - 0.61）到物理治疗门诊的完美一致性（kappa = 1.0）不等。
通过评估和规范一种资源及成本核算工具，如AHCR，可以改进经济评估，并对不同服务和不同人群的资源影响进行比较。
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