Département de Gestion, Évaluation et Politique de Santé, École de santé publique de l'Université de Montréal, Montreal, Canada.
Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Canada.
Patient. 2022 Jan;15(1):3-19. doi: 10.1007/s40271-021-00527-x. Epub 2021 Jun 5.
Increasing healthcare expenditures is a major concern to insurers and governments, but also to patients who must pay a greater proportion of their healthcare costs. The objective of this study was to identify validated tools for measuring the costs of a health condition for patients as well as the different elements to be considered when measuring costs from the patient's perspective.
A systematic literature review was conducted from 1984 to December 2020. The search strategy was applied to seven different databases that had been identified prior as pertinent sources. Two authors independently extracted and compiled data. In case of disagreement, arbitration by two other researchers was conducted. The methodological quality of the included articles was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.
Among the 679 retrieved articles, nine met the inclusion criteria. The types of costs evaluated in these studies included direct costs for patients as well as for caregivers, indirect costs, and intangible costs. The development and validation processes used in these articles included a literature search, a discussion with the involved stakeholders, the development of an initial questionnaire, the testing of the questionnaire on a sample of patients, and a critical review. Regarding the psychometric properties of the tool, only five studies tested the reliability and validity of the instrument.
There are very few validated tools available to measure the different health-related costs from a patient perspective. Further research is needed to develop and validate a versatile and generalizable tool using a rigorous methodological process.
医疗保健支出的增加是保险公司和政府的主要关注点，但也是患者必须支付更多医疗费用的主要关注点。本研究的目的是确定用于衡量患者健康状况成本的经过验证的工具，以及从患者角度衡量成本时需要考虑的不同因素。
从 1984 年到 2020 年 12 月进行了系统的文献回顾。搜索策略应用于之前确定为相关来源的七个不同数据库。两名作者独立提取和编译数据。如果存在分歧，则由另外两名研究人员进行仲裁。使用共识标准选择健康测量工具（COSMIN）检查表评估纳入文章的方法学质量。
在检索到的 679 篇文章中，有 9 篇符合纳入标准。这些研究评估的成本类型包括患者和护理人员的直接成本、间接成本和无形成本。这些文章中使用的开发和验证过程包括文献检索、与相关利益相关者的讨论、初始问卷的制定、对患者样本进行问卷测试以及批判性审查。关于工具的心理测量特性，只有五项研究测试了仪器的可靠性和有效性。
从患者角度衡量不同健康相关成本的经过验证的工具非常少。需要进一步研究，以使用严格的方法学过程开发和验证一种通用且可推广的工具。
