A general framework for classifying costing methods for economic evaluation of health care

According to the most traditional economic evaluation manuals, all “relevant” costs should be included in the economic analysis,
taking into account factors such as the patient population, setting, location, year, perspective and time horizon. However,
cost information may be designed for other purposes. Health care organisations may lack sophisticated accounting systems
and consequently, health economists may be unfamiliar with cost accounting terminology, which may lead to discrepancy
in terms used in the economic evaluation literature and management accountancy. This paper identifies new tendencies in
costing methodologies in health care and critically comments on each included article. For better clarification of terminology,
a pragmatic glossary of terms is proposed. A scoping review of English and Spanish language literature (2005–2018) was
conducted to identify new tendencies in costing methodologies in health care. The databases PubMed, Scopus and EconLit
were searched. A total of 21 studies were included yielding 43 costing analysis. The most common analysis was top-down
micro-costing (49%), followed by top-down gross-costing (37%) and bottom-up micro-costing (14%). Resource data were
collected prospectively in 12 top-down studies (32%). Hospital database was the most common way of collection of resource
data (44%) in top-down gross-costing studies. In top-down micro-costing studies, the most resource use data collection was
the combination of several methods (38%). In general, substantial inconsistencies in the costing methods were found. The
convergence of top-down and bottom-up methods may be an important topic in the next decades.