Page 70 - Htain Manual

1. Outline the aims and objectives of the costing exercise explicitly and make a list of

services or packages, whose costing is planned. Researchers should also acknowledge

existing data sources, facilitators and barriers in obtaining data, budgeting and

timeline etc. Plan of study can be discussed with all the stakeholders to streamline the
data collection process and to ensure the acceptance of results.

2. Decide the perspective of costing study according to requirements of the policy

question. The perspective would indicate which all costs are to be included in the
analysis. This depends upon context and nature of service being delivered. See box

below to know about all three types of perspectives. Also clearly define all the

inclusion and exclusion criteria for resources being utilized for provision of the service

(e. g. whether time and budget of study allows researchers to estimate productivity

losses of the patient or not). Researchers should try to include as many resources as
possible, keeping feasibility of the study into consideration.

3. Take guidance from reference case or existing evidence and choose appropriate

methodology for costing. Costing methodology (top-down/bottom-up/mixed
methodology) should be selected based on priorities of all the stakeholders and

resources available. Time horizon, approach for data collection

(prospective/retrospective) and data period (year/month) should be well-defined.

4. Select appropriate sample of service providers based on type of ownership, city of

location (rural/urban), level of healthcare facility (primary/secondary/tertiary),
occupancy rates and quality of service (NABH or other quality accreditation). If costing

is being done for economic evaluation or HTA, characteristics (severity of disease or

age) of patients should be same during estimation of cost as well as effectiveness.
5. Identify all the cost centres in given sample of hospitals (OPD/ward/OT/laundry etc.)

and prepare appropriate data collection template or tool. Data collection tool must be

comprehensive enough to include all sources utilized under different heads, all capital

as well recurrent resources. There should be provision to collect data required for

apportioning of shared resources.

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