Donaldson C
Department of Community Medicine, Westmead Hospital, NSW.
Community Health Stud. 1990;14(4):341-56. doi: 10.1111/j.1753-6405.1990.tb00045.x.
In this paper, the principles of costing health care for economic evaluation are outlined. Hypothetical and published examples are used to illustrate these principles. First, the economic concept of opportunity cost is defined. Secondly, the techniques of economic evaluation which follow from this definition are introduced: they are cost-benefit analysis, cost-effectiveness analysis and cost-utility analysis. Thirdly, a list of costs which should be considered for inclusion in either of these types of evaluation is provided, this listing being based on the concept of opportunity cost. Problems of measurement and valuation of costs are then outlined, focusing in particular on inflation, discounting, marginal costing, patient-based versus per diem costing, allocating overheads, costing capital and equipment and adjusting distorted market valuations. An example of sensitivity analysis is provided and also a checklist of questions to ask when setting up any costing exercise within an economic evaluation.
本文概述了用于经济评估的医疗保健成本核算原则。通过假设示例和已发表的实例来说明这些原则。首先，定义了机会成本的经济概念。其次，介绍了基于该定义的经济评估技术：成本效益分析、成本效果分析和成本效用分析。第三，提供了一份应纳入这些评估类型中任一种的成本清单，该清单基于机会成本的概念。接着概述了成本计量和估值问题，特别关注通货膨胀、贴现、边际成本核算、基于患者与每日成本核算、间接费用分摊、资本和设备成本核算以及调整扭曲的市场估值。提供了一个敏感性分析示例以及在经济评估中进行任何成本核算工作时要问的问题清单。
