Smith Samantha, Jiang Jingjing, Normand Charles, O'Neill Ciaran
Centre for Health Policy and Management, Trinity College Dublin, Dublin, Ireland.
Cicely Saunders Institute, London, SE5 9PJ, UK.
HRB Open Res. 2021 Apr 23;4:39. doi: 10.12688/hrbopenres.13256.1. eCollection 2021.
This paper presents detailed unit costs for 16 healthcare professionals in community-based non-acute services in Ireland for the years 2016-2019. Unit costs are important data inputs for assessments of health service performance and value for money. Internationally, while some countries have an established database of unit costs for healthcare, there is need for a more coordinated approach to calculating healthcare unit costs. In Ireland, detailed cost analysis of acute care is undertaken by the Healthcare Pricing Office but to date there has been no central database of unit costs for community-based non-acute healthcare services. Unit costs for publicly employed allied healthcare professionals, Public Health Nurses and Health Care Assistant staff are calculated using a bottom-up micro-costing approach, drawing on methods outlined by the Personal Social Services Research Unit in the UK, and on available Irish and international costing guidelines. Data on salaries, working hours and other parameters are drawn from secondary datasets available from Department of Health, Health Service Executive and other public sources. Unit costs for public and private General Practitioner, dental, and long-term residential care (LTRC) are estimated drawing on available administrative and survey data. The unit costs for the publicly employed non-acute healthcare professionals have changed by 2-6% over the timeframe 2016-2019 while larger percentage changes are observed in the unit costs for public GP visits and public LTRC (14-15%). The costs presented here are a first step towards establishing a central database of unit costs for non-acute healthcare services in Ireland. The database will help ensure consistency across Irish health costing studies and facilitate cross-study and cross-country comparisons. Future work will be required to update and expand on the range of services covered and to incorporate new data and methodological developments in cost estimation as they become available.
本文展示了2016年至2019年爱尔兰社区非急性服务中16名医疗保健专业人员的详细单位成本。单位成本是评估卫生服务绩效和性价比的重要数据输入。在国际上，虽然一些国家已经建立了医疗保健单位成本数据库，但仍需要一种更协调的方法来计算医疗保健单位成本。在爱尔兰，医疗保健定价办公室对急性护理进行了详细的成本分析，但迄今为止，尚未建立基于社区的非急性医疗保健服务单位成本的中央数据库。使用自下而上的微观成本核算方法，借鉴英国个人社会服务研究单位概述的方法以及爱尔兰和国际可用的成本核算指南，计算公共雇佣的专职医疗保健专业人员、公共卫生护士和医疗保健助理人员的单位成本。工资、工作时间和其他参数的数据来自卫生部、卫生服务执行局和其他公共来源的二手数据集。根据可用的行政和调查数据估算公共和私人全科医生、牙科和长期住院护理（LTRC）的单位成本。在2016 - 2019年期间，公共雇佣的非急性医疗保健专业人员的单位成本变化了2 - 6%，而公共全科医生就诊和公共LTRC的单位成本变化百分比更大（14 - 15%）。这里呈现的成本是朝着建立爱尔兰非急性医疗保健服务单位成本中央数据库迈出的第一步。该数据库将有助于确保爱尔兰卫生成本研究的一致性，并促进跨研究和跨国比较。未来需要开展工作来更新和扩大所涵盖的服务范围，并在有新数据和成本估算方法发展时将其纳入。
