Clabaugh Gerd, Ward Marcia M
Department of Health Management and Policy, University of Iowa, Iowa City, IA, USA.
Value Health. 2008 Jan-Feb;11(1):13-21. doi: 10.1111/j.1524-4733.2007.00210.x.
We undertake a systematic review to examine the methods used by researchers in developing cost-of-illness (COI) studies. This review aims to categorize the approaches that the published literature uses in terms of perspective, scope, components of care analyzed in the literature, data sets, and valuation approaches used for direct cost. It draws conclusions regarding the adequacy of current COI research methods and makes recommendations on improving them.
The online bibliographic information service HealthSTAR (which incorporates MEDLINE) was used to search for COI studies in the research literature published during the period from 2000 to 2004. The search strategy used the term "cost of illness" as a MeSH (medical subject heading) term.
The HealthSTAR literature search identified references to 650 articles. Review of abstracts resulted in the identification of 170 of these for a more detailed review. This process identified 52 articles that met all criteria of COI studies. We identified 218 components of care analyzed across the 52 articles. Private-insurance or employer-claims data sets comprised the largest source of utilization and cost information among the studies.
Analyzing cost of illness presents useful opportunities for communicating with the public and policymakers on the relative importance of specific diseases and injuries. Our research, however, indicates that COI studies employ varied approaches and many articles have methodological limitations. Without well-accepted standards to guide researchers in their execution of these studies, policymakers and the general public must be wary of the methods used in their calculation and subsequent results.
我们进行了一项系统综述，以考察研究人员在开展疾病成本（COI）研究时所使用的方法。本综述旨在根据视角、范围、文献中分析的护理组成部分、数据集以及用于直接成本的估值方法，对已发表文献中使用的方法进行分类。它得出了关于当前COI研究方法充分性的结论，并就改进这些方法提出了建议。
利用在线书目信息服务HealthSTAR（其中包含MEDLINE），在2000年至2004年期间发表的研究文献中搜索COI研究。搜索策略使用“疾病成本”作为医学主题词（MeSH）。
HealthSTAR文献搜索识别出650篇文章的参考文献。对摘要的审查导致从中确定了170篇进行更详细的审查。这一过程确定了52篇符合COI研究所有标准的文章。我们在这52篇文章中识别出218个分析的护理组成部分。在这些研究中，私人保险或雇主索赔数据集是使用和成本信息的最大来源。
分析疾病成本为就特定疾病和伤害的相对重要性与公众和政策制定者进行沟通提供了有用的机会。然而，我们的研究表明，COI研究采用了多种方法，许多文章存在方法学上的局限性。由于缺乏被广泛接受的标准来指导研究人员开展这些研究，政策制定者和公众必须对计算中使用的方法及其后续结果保持警惕。
