Lifetime costs for medical services: a methodological review.
OBJECTIVE
Guidelines for economic evaluation studies recommend that modeling be undertaken to estimate long-term, downstream costs. In this study, we conduct a review of a sample of studies that estimated the lifetime medical care costs for a variety of conditions.


METHODS
We developed a categorization of the elements for a lifetime-costing study and based on these elements, we abstracted information from a sample of 33 papers in the following areas: study subject, purpose, scope, methods (including time profile, utilization, and cost), and results.


RESULTS
We analyzed papers that were observational, models or that combined the two approaches. The time profiles were estimated from registry and published data. Utilization data were obtained from administrative data, chart reviews, and professional opinion. Costs were obtained from administrative and financial records and were estimated using all charges, allocated costs, and provider payments. We noted wide variations in methods and reporting practices.


CONCLUSIONS
Following current guidelines (CCOHTA), lifetime models can be more easily interpreted and applied if investigators are more clear in their study aims, if they incorporate assumptions that are based on current data, if they follow current methodological practices (such as deflation, discounting, and sensitivity analyses), and if reporting is more transparent.
Jacobs
Philip
P
University of Alberta, Canada. philip.jacobs@ualberta.ca
Golmohammadi
Kamran
K
Longobardi
Teresa
T
D002170:Canada; D017281:Cost of Illness; D017408:Guidelines as Topic; D005102:Health Expenditures; D006801:Humans; D015993:Life Tables; D008137:Longitudinal Studies; D017059:Models, Econometric