B Graham1, K McGregor. 1. Department of Orthopaedic Surgery, University of Edinburgh.
Abstract
BACKGROUND: Demand for information regarding the cost-effectiveness of health care treatment options is growing. It is necessary to derive unit costs for services, such as general practice (GP) consultations, in order to inform the economic evaluation. AIM: To review the literature, provide a description of the three key steps that should be followed in the costing process and to provide a method for updating costs calculated in previous years. METHOD: A literature search was carried out to identify references that specifically describe the cost of a consultation in general practice. A total of 20 references were extracted, categorized and reviewed. A cost-price index for health care goods was obtained from the British Medical Association and used to construct a table to allow rapid reference and updating of cost results. The costs reported in the literature were updated and compared. RESULTS: Twenty published studies referring to the unit cost of a GP consultation were located in the searches. Half of these did not describe the methodology used to derive the costs; of those that did, less than half covered the necessary steps to derive unit costs. The cost of an average 10-minute consultation in 1995/96 figures was estimated to be 6.90 +/- 2.73 pounds. CONCLUSION: Great variation exists regarding the methodology for costing a GP consultation. If the methods used are stated explicitly and incorporate the three steps described, then results obtained in previous years may be updated using the cost-price index as shown (Table 1). Interpretation in this area must be made with caution.
BACKGROUND: Demand for information regarding the cost-effectiveness of health care treatment options is growing. It is necessary to derive unit costs for services, such as general practice (GP) consultations, in order to inform the economic evaluation. AIM: To review the literature, provide a description of the three key steps that should be followed in the costing process and to provide a method for updating costs calculated in previous years. METHOD: A literature search was carried out to identify references that specifically describe the cost of a consultation in general practice. A total of 20 references were extracted, categorized and reviewed. A cost-price index for health care goods was obtained from the British Medical Association and used to construct a table to allow rapid reference and updating of cost results. The costs reported in the literature were updated and compared. RESULTS: Twenty published studies referring to the unit cost of a GP consultation were located in the searches. Half of these did not describe the methodology used to derive the costs; of those that did, less than half covered the necessary steps to derive unit costs. The cost of an average 10-minute consultation in 1995/96 figures was estimated to be 6.90 +/- 2.73 pounds. CONCLUSION: Great variation exists regarding the methodology for costing a GP consultation. If the methods used are stated explicitly and incorporate the three steps described, then results obtained in previous years may be updated using the cost-price index as shown (Table 1). Interpretation in this area must be made with caution.