Methodologic principles of cost analyses in the nursing, medical, and health services literature, 1990-1996

Wen Yin Chang, Beverly M. Henry

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Cost analyses are needed to inform resource decisions. Oftentimes, however cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), cost-minimization analysis (CMA), and cost-utility analysis (CUA) are performed using untested techniques and adhering to a variety of questionable principles. Objectives: To analyze, compare, and present a set of useful principles for the main types and methods of cost analyses through a synthesis of current information in the published literature. Methods: The area of interest included all reports of cost research published as full articles in professional journals from January 1990 to August 1996 in the nursing, medical, and health services fields. In all, 88 sampled articles met the criteria for inclusion. A four-page data collection guide with 28 items grouped as demographics, cost-analysis types, methods, and principles was designed for the review. Incremental testing for interrater reliability using the kappa statistic for two raters was performed. Sampling, process-oriented, construct, and correlational validity were assessed. Results: The 88 articles included 4 from nursing, 59 from medical, and 25 from health services journals. Of these articles, 45 (51%) reported CBA, 36 (41%) CEA, 2 CMA, 4 CUA, and 1 both CBA and CEA. Three nursing studies were authored only by nurses. Three fourths of the medical and four fifths of the health services publications had interdisciplinary authorship. Existing databases were the primary source of data in 61 (69%) publications. Adherence to six main methodologic principles was apparent in 19 (22%) articles. None of the nursing studies adhered to all six principles, whereas 16% of the health services and 25% of the medical studies did. Conclusions: Funded cost analyses of nursing interventions that adhere to the six known methodologic principles are needed to inform policy-level health care decisions. Because of the complexity of cost analysis methodology, including sensitivity analysis, future interdisciplinary efforts using existing databases may prove most effective. The six methodologic principles presented in this article can be useful for future nursing education and cost-analysis research designed to control cost and increase the quality of health care.

Original languageEnglish
Pages (from-to)94-104
Number of pages11
JournalNursing Research
Volume48
Issue number2
Publication statusPublished - Mar 1999
Externally publishedYes

Fingerprint

Nursing Services
Health Services
Cost-Benefit Analysis
Costs and Cost Analysis
Nursing
Publications
Databases
Authorship
Cost Control
Quality of Health Care
Nursing Education
Information Storage and Retrieval
Systems Analysis
Research
Health Status

Keywords

  • Cost analysis
  • Economic evaluation
  • Methodologic principles

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Methodologic principles of cost analyses in the nursing, medical, and health services literature, 1990-1996. / Chang, Wen Yin; Henry, Beverly M.

In: Nursing Research, Vol. 48, No. 2, 03.1999, p. 94-104.

Research output: Contribution to journalArticle

@article{3d51b85cb79e4c548086eeeac7825d00,
title = "Methodologic principles of cost analyses in the nursing, medical, and health services literature, 1990-1996",
abstract = "Background: Cost analyses are needed to inform resource decisions. Oftentimes, however cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), cost-minimization analysis (CMA), and cost-utility analysis (CUA) are performed using untested techniques and adhering to a variety of questionable principles. Objectives: To analyze, compare, and present a set of useful principles for the main types and methods of cost analyses through a synthesis of current information in the published literature. Methods: The area of interest included all reports of cost research published as full articles in professional journals from January 1990 to August 1996 in the nursing, medical, and health services fields. In all, 88 sampled articles met the criteria for inclusion. A four-page data collection guide with 28 items grouped as demographics, cost-analysis types, methods, and principles was designed for the review. Incremental testing for interrater reliability using the kappa statistic for two raters was performed. Sampling, process-oriented, construct, and correlational validity were assessed. Results: The 88 articles included 4 from nursing, 59 from medical, and 25 from health services journals. Of these articles, 45 (51{\%}) reported CBA, 36 (41{\%}) CEA, 2 CMA, 4 CUA, and 1 both CBA and CEA. Three nursing studies were authored only by nurses. Three fourths of the medical and four fifths of the health services publications had interdisciplinary authorship. Existing databases were the primary source of data in 61 (69{\%}) publications. Adherence to six main methodologic principles was apparent in 19 (22{\%}) articles. None of the nursing studies adhered to all six principles, whereas 16{\%} of the health services and 25{\%} of the medical studies did. Conclusions: Funded cost analyses of nursing interventions that adhere to the six known methodologic principles are needed to inform policy-level health care decisions. Because of the complexity of cost analysis methodology, including sensitivity analysis, future interdisciplinary efforts using existing databases may prove most effective. The six methodologic principles presented in this article can be useful for future nursing education and cost-analysis research designed to control cost and increase the quality of health care.",
keywords = "Cost analysis, Economic evaluation, Methodologic principles",
author = "Chang, {Wen Yin} and Henry, {Beverly M.}",
year = "1999",
month = "3",
language = "English",
volume = "48",
pages = "94--104",
journal = "Nursing Research",
issn = "0029-6562",
publisher = "Lippincott Williams and Wilkins",
number = "2",

}

TY - JOUR

T1 - Methodologic principles of cost analyses in the nursing, medical, and health services literature, 1990-1996

AU - Chang, Wen Yin

AU - Henry, Beverly M.

PY - 1999/3

Y1 - 1999/3

N2 - Background: Cost analyses are needed to inform resource decisions. Oftentimes, however cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), cost-minimization analysis (CMA), and cost-utility analysis (CUA) are performed using untested techniques and adhering to a variety of questionable principles. Objectives: To analyze, compare, and present a set of useful principles for the main types and methods of cost analyses through a synthesis of current information in the published literature. Methods: The area of interest included all reports of cost research published as full articles in professional journals from January 1990 to August 1996 in the nursing, medical, and health services fields. In all, 88 sampled articles met the criteria for inclusion. A four-page data collection guide with 28 items grouped as demographics, cost-analysis types, methods, and principles was designed for the review. Incremental testing for interrater reliability using the kappa statistic for two raters was performed. Sampling, process-oriented, construct, and correlational validity were assessed. Results: The 88 articles included 4 from nursing, 59 from medical, and 25 from health services journals. Of these articles, 45 (51%) reported CBA, 36 (41%) CEA, 2 CMA, 4 CUA, and 1 both CBA and CEA. Three nursing studies were authored only by nurses. Three fourths of the medical and four fifths of the health services publications had interdisciplinary authorship. Existing databases were the primary source of data in 61 (69%) publications. Adherence to six main methodologic principles was apparent in 19 (22%) articles. None of the nursing studies adhered to all six principles, whereas 16% of the health services and 25% of the medical studies did. Conclusions: Funded cost analyses of nursing interventions that adhere to the six known methodologic principles are needed to inform policy-level health care decisions. Because of the complexity of cost analysis methodology, including sensitivity analysis, future interdisciplinary efforts using existing databases may prove most effective. The six methodologic principles presented in this article can be useful for future nursing education and cost-analysis research designed to control cost and increase the quality of health care.

AB - Background: Cost analyses are needed to inform resource decisions. Oftentimes, however cost-benefit analysis (CBA), cost-effectiveness analysis (CEA), cost-minimization analysis (CMA), and cost-utility analysis (CUA) are performed using untested techniques and adhering to a variety of questionable principles. Objectives: To analyze, compare, and present a set of useful principles for the main types and methods of cost analyses through a synthesis of current information in the published literature. Methods: The area of interest included all reports of cost research published as full articles in professional journals from January 1990 to August 1996 in the nursing, medical, and health services fields. In all, 88 sampled articles met the criteria for inclusion. A four-page data collection guide with 28 items grouped as demographics, cost-analysis types, methods, and principles was designed for the review. Incremental testing for interrater reliability using the kappa statistic for two raters was performed. Sampling, process-oriented, construct, and correlational validity were assessed. Results: The 88 articles included 4 from nursing, 59 from medical, and 25 from health services journals. Of these articles, 45 (51%) reported CBA, 36 (41%) CEA, 2 CMA, 4 CUA, and 1 both CBA and CEA. Three nursing studies were authored only by nurses. Three fourths of the medical and four fifths of the health services publications had interdisciplinary authorship. Existing databases were the primary source of data in 61 (69%) publications. Adherence to six main methodologic principles was apparent in 19 (22%) articles. None of the nursing studies adhered to all six principles, whereas 16% of the health services and 25% of the medical studies did. Conclusions: Funded cost analyses of nursing interventions that adhere to the six known methodologic principles are needed to inform policy-level health care decisions. Because of the complexity of cost analysis methodology, including sensitivity analysis, future interdisciplinary efforts using existing databases may prove most effective. The six methodologic principles presented in this article can be useful for future nursing education and cost-analysis research designed to control cost and increase the quality of health care.

KW - Cost analysis

KW - Economic evaluation

KW - Methodologic principles

UR - http://www.scopus.com/inward/record.url?scp=0033094146&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033094146&partnerID=8YFLogxK

M3 - Article

VL - 48

SP - 94

EP - 104

JO - Nursing Research

JF - Nursing Research

SN - 0029-6562

IS - 2

ER -