title: Mixed method versus full top-down microcosting for organ recovery cost assessment in a French hospital group.
abstract: BACKGROUND
  The costing method used can change the results of economic evaluations. Choosing the appropriate method to assess the cost of organ recovery is an issue of considerable interest to health economists, hospitals, financial managers and policy makers in most developed countries.
  
  
  OBJECTIVE
  The main objective of this study was to compare a mixed method, combining top-down microcosting and bottom-up microcosting versus full top-down microcosting to assess the cost of organ recovery in a French hospital group. The secondary objective was to describe the cost of kidney, liver and pancreas recovery from French databases using the mixed method.
  
  
  METHODS
  The resources consumed for each donor were identified and valued using the proposed mixed method and compared to the full top-down microcosting approach. Data on kidney, liver and pancreas recovery were collected from a medico-administrative French database for the years 2010 and 2011. Related cost data were recovered from the hospital cost accounting system database for 2010 and 2011. Statistical significance was evaluated at P < 0.05.
  
  
  RESULTS
  All the median costs for organ recovery differ significantly between the two costing methods (non-parametric test method; P < 0.01). Using the mixed method, the median cost for recovering kidneys was found to be €5155, liver recovery was €2528 and pancreas recovery was €1911. Using the full top-down microcosting method, median costs were found to be 21-36% lower than with the mixed method.
  
  
  CONCLUSIONS
  The mixed method proposed appears to be a trade-off between feasibility and accuracy for the identification and valuation of cost components when calculating the cost of organ recovery in comparison to the full top-down microcosting approach.
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Evaluation Médico-Economique, 162, avenue Lacassagne - Bâtiment A, 69424, Lyon, Cedex 03, France. abdelbaste.hrifach@chu-lyon.fr.|Univ. Lyon, Université Claude Bernard Lyon 1, HESPER EA 7425, F-69008, Lyon, France. abdelbaste.hrifach@chu-lyon.fr.
authors.forename: Abdelbaste
authors.initials: A
authors.lastname: Hrifach
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Evaluation Médico-Economique, 162, avenue Lacassagne - Bâtiment A, 69424, Lyon, Cedex 03, France.
authors.forename: Coralie
authors.initials: C
authors.lastname: Brault
authors.affiliation: Département d'Information Médicale, Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, 69424, Lyon, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Couray-Targe
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Urologie, 69437, Lyon, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Badet
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Evaluation Médico-Economique, 162, avenue Lacassagne - Bâtiment A, 69424, Lyon, Cedex 03, France.|Hospices Civils de Lyon, Cellule Innovation, Délégation à la Recherche Clinique et à l'Innovation, 69237, Lyon, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Guerre
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Evaluation Médico-Economique, 162, avenue Lacassagne - Bâtiment A, 69424, Lyon, Cedex 03, France.|Département d'Information Médicale, Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, 69424, Lyon, France.
authors.forename: Christell
authors.initials: C
authors.lastname: Ganne
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Evaluation Médico-Economique, 162, avenue Lacassagne - Bâtiment A, 69424, Lyon, Cedex 03, France.|Hospices Civils de Lyon, Cellule Innovation, Délégation à la Recherche Clinique et à l'Innovation, 69237, Lyon, France.
authors.forename: Hassan
authors.initials: H
authors.lastname: Serrier
authors.affiliation: Hospices Civils de Lyon, Hôpital Edouard Herriot, Coordination Hospitalière de Prélèvement d'Organes et de Tissus, 69437, Lyon, France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Labeye
authors.affiliation: Université Claude Bernard Lyon 1, 69008, Lyon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Farge
authors.affiliation: Hospices Civils de Lyon, Pôle Information Médicale Evaluation Recherche, Unité d'Evaluation Médico-Economique, 162, avenue Lacassagne - Bâtiment A, 69424, Lyon, Cedex 03, France.|Université Claude Bernard Lyon 1, 69008, Lyon, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Colin
keywords: Bottom-up; Microcosting; Organ recovery; Top-down