Abstract
Background
Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than methodological evidence. Furthermore, few resource-use measurement (RUM) instruments focus on the measurement of resource use in multiple societal sectors and their development process is rarely described. Thorn and colleagues proposed a stepwise approach to the development of RUM instruments, which has been used for developing cost questionnaires for specific trials. However, it remains unclear how this approach can be translated into practice and whether it is applicable to the development of generic self-reported RUM instruments and instruments measuring resource use in multiple sectors. This study provides a detailed description of the practical application of this stepwise approach to the development of a multi-sectoral RUM instrument developed within the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) project.
Methods
For the development of the PECUNIA RUM, the methodological approach was based on best practice guidelines. The process included six steps, including the definition of the instrument attributes, identification of cost-driving elements in each sector, review of methodological literature and development of a harmonized cross-sectorial approach, development of questionnaire modules and their subsequent harmonization.
Results
The selected development approach was, overall, applicable to the development of the PECUNIA RUM. However, due to the complexity of the development of a multi-sectoral RUM instrument, additional steps such as establishing a uniform methodological basis, harmonization of questionnaire modules and involvement of a broader range of stakeholders (healthcare professionals, sector-specific experts, health economists) were needed.
Conclusion
This is the first study that transparently describes the development process of a generic multi-sectoral RUM instrument in health economics and provides insights into the methodological aspects and overall validity of its development process.
Measuring objective resource-use quantities is important for generating valid cost estimates in economic evaluations. In the absence of acknowledged guidelines, measurement methods are often chosen based on practicality rather than methodological evidence. Furthermore, few resource-use measurement (RUM) instruments focus on the measurement of resource use in multiple societal sectors and their development process is rarely described. Thorn and colleagues proposed a stepwise approach to the development of RUM instruments, which has been used for developing cost questionnaires for specific trials. However, it remains unclear how this approach can be translated into practice and whether it is applicable to the development of generic self-reported RUM instruments and instruments measuring resource use in multiple sectors. This study provides a detailed description of the practical application of this stepwise approach to the development of a multi-sectoral RUM instrument developed within the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA) project.
Methods
For the development of the PECUNIA RUM, the methodological approach was based on best practice guidelines. The process included six steps, including the definition of the instrument attributes, identification of cost-driving elements in each sector, review of methodological literature and development of a harmonized cross-sectorial approach, development of questionnaire modules and their subsequent harmonization.
Results
The selected development approach was, overall, applicable to the development of the PECUNIA RUM. However, due to the complexity of the development of a multi-sectoral RUM instrument, additional steps such as establishing a uniform methodological basis, harmonization of questionnaire modules and involvement of a broader range of stakeholders (healthcare professionals, sector-specific experts, health economists) were needed.
Conclusion
This is the first study that transparently describes the development process of a generic multi-sectoral RUM instrument in health economics and provides insights into the methodological aspects and overall validity of its development process.
| Original language | English |
|---|---|
| Pages (from-to) | 155-166 |
| Number of pages | 12 |
| Journal | Applied Health Economics and Health Policy |
| Volume | 21 |
| Issue number | 2 |
| Early online date | 9 Jan 2023 |
| DOIs | |
| Publication status | Published - 1 Mar 2023 |
Bibliographical note
Funding Information:The authors would like to thank the experts who participated in the PECUNIA satellite workshop in July 2019, during which the methodological approach to the development of the PECUNIA RUM was presented and discussed. The authors would also like to thank the experts who participated in the expert meeting at the annual ISPOR conference in 2019, during which the draft version of the PECUNIA RUM was presented, and Nataša Perić (Medical University of Vienna) who facilitated the organization of this meeting. This manuscript was discussed at the 2020 EuHEA PhD Student-Supervisor and Early Career Researcher and at the lolaHESG conference in September 2020. The authors would like to thank the discussants and all others who were present and contributed to the discussion. This manuscript was written on behalf of the PECUNIA Group. Members of the PECUNIA Group are: Medical University of Vienna: Principal investigator (PI): Judit Simon; team members (in alphabetical order): Michael Berger, Claudia Fischer, Agata Łaszewska, Susanne Mayer, Nataša Perić. University Medical Center Hamburg-Eppendorf: PI: Hans-Helmut König; team members (in alphabetical order): Christian Brettschneider, Marie Christine Duval, Paul Hinck, Johanna Katharina Hohls, Alexander Konnopka, Louisa-Kristin Muntendorf. Corvinus University of Budapest: PI: Valentin Brodszky; team members: László Gulácsi. Maastricht University: PI: Silvia M.A.A. Evers; team members (in alphabetical order): Ruben M.W.A. Drost, Luca M.M. Janssen, Aggie T.G. Paulus, Irina Pokhilenko. Erasmus University Rotterdam: PI: Leona Hakkaart-van Roijen; team members (in alphabetical order): Kimberley Hubens, Ayesha Sajjad. Servicio de Evaluación del Canario de la Salud: PI: Pedro Serrano-Aguilar; team members (in alphabetical order): Lidia García-Pérez, Renata Linertová, Lilisbeth Perestelo-Pérez, Cristina Valcárcel-Nazco. PSICOST Scientific Association: PI: Luis Salvador-Carulla; team members (in alphabetical order): Nerea Almeda, Pilar Campoy-Muñoz, Carlos R. García-Alonso, Mencía R. Gutiérrez-Colosía, Cristina Romero-López-Alberca. London School of Economics and Political Science: PI: A-La Park University of Bristol: PI: William Hollingworth; team members (in alphabetical order): Sian Noble, Joanna Thorn.
Funding Information:
This study was conducted alongside the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA), which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 779292.
Publisher Copyright:
© 2023, The Author(s).
Research Groups and Themes
- HEHP@Bristol