Paddy Gillespie1, Eamon O'Shea2, Susan M Smith3, Margaret E Cupples4, Andrew W Murphy5. 1. School of Business and Economics, National University of Ireland, Galway, Ireland, paddy.gillespie@nuigalway.ie. 2. School of Business and Economics, National University of Ireland, Galway, Ireland. 3. Department of General Practice, Royal College of Surgeons, Dublin, Ireland. 4. Department of General Practice and Primary Care, UKCRC Centre of Excellence for Public Health Research, Queen's University Belfast, Belfast, Northern Ireland, UK and. 5. School of Medicine, National University of Ireland, Galway, Ireland.
Abstract
BACKGROUND: Data on health care utilization may be collected using a variety of mechanisms within research studies, each of which may have implications for cost and cost effectiveness. OBJECTIVE: The aim of this observational study is to compare data collected from medical records searches and self-report questionnaires for the cost analysis of a cardiac secondary prevention intervention. METHODS: Secondary data analysis of the Secondary Prevention of Heart Disease in General Practice (SPHERE) randomized controlled trial (RCT). Resource use data for a range of health care services were collected by research nurse searches of medical records and self-report questionnaires and costs of care estimated for each data collection mechanism. A series of statistical analyses were conducted to compare the mean costs for medical records data versus questionnaire data and to conduct incremental analyses for the intervention and control arms in the trial. RESULTS: Data were available to estimate costs for 95% of patients in the intervention and 96% of patients in the control using the medical records data compared to 65% and 66%, respectively, using the questionnaire data. The incremental analysis revealed a statistically significant difference in mean cost of -€796 (95% CI: -1447, -144; P-value: 0.017) for the intervention relative to the control. This compared to no significant difference in mean cost (95% CI: -1446, 860; P-value: 0.619) for the questionnaire analysis. CONCLUSIONS: Our findings illustrate the importance of the choice of health care utilization data collection mechanism for the conduct of economic evaluation alongside randomized trials in primary care. This choice will have implications for the costing methodology employed and potentially, for the cost and cost effectiveness outcomes generated.
BACKGROUND: Data on health care utilization may be collected using a variety of mechanisms within research studies, each of which may have implications for cost and cost effectiveness. OBJECTIVE: The aim of this observational study is to compare data collected from medical records searches and self-report questionnaires for the cost analysis of a cardiac secondary prevention intervention. METHODS: Secondary data analysis of the Secondary Prevention of Heart Disease in General Practice (SPHERE) randomized controlled trial (RCT). Resource use data for a range of health care services were collected by research nurse searches of medical records and self-report questionnaires and costs of care estimated for each data collection mechanism. A series of statistical analyses were conducted to compare the mean costs for medical records data versus questionnaire data and to conduct incremental analyses for the intervention and control arms in the trial. RESULTS: Data were available to estimate costs for 95% of patients in the intervention and 96% of patients in the control using the medical records data compared to 65% and 66%, respectively, using the questionnaire data. The incremental analysis revealed a statistically significant difference in mean cost of -€796 (95% CI: -1447, -144; P-value: 0.017) for the intervention relative to the control. This compared to no significant difference in mean cost (95% CI: -1446, 860; P-value: 0.619) for the questionnaire analysis. CONCLUSIONS: Our findings illustrate the importance of the choice of health care utilization data collection mechanism for the conduct of economic evaluation alongside randomized trials in primary care. This choice will have implications for the costing methodology employed and potentially, for the cost and cost effectiveness outcomes generated.
Authors: Anne-Marie Miller; Robert Behan; Ian Smith; Matthew Griffin; Fionnuala Keane; James Langan; Colm O'Rourke; Niall McAleenan; Abhay Pandit; Mark Watson Journal: Health Policy Technol Date: 2020-10-15
Authors: Chantal L Grimwood; Anne E Holland; Christine F McDonald; Ajay Mahal; Catherine J Hill; Annemarie L Lee; Narelle S Cox; Rosemary Moore; Caroline Nicolson; Paul O'Halloran; Aroub Lahham; Rebecca Gillies; Angela T Burge Journal: BMC Health Serv Res Date: 2020-11-23 Impact factor: 2.655
Authors: Emma Wallace; Frank Moriarty; Christine McGarrigle; Susan M Smith; Rose-Anne Kenny; Tom Fahey Journal: PLoS One Date: 2018-10-26 Impact factor: 3.240