Examination of health care costing methodologies: a comparison of the UK and Ontario

Fitzsimmons, Deborah A. (2005) Examination of health care costing methodologies: a comparison of the UK and Ontario. Doctoral thesis, University of Central Lancashire.

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This research builds upon a body of work on the development and introduction of information systems in the UK National Health Service following the implementation of the White Paper 'Working for Patients'. None of the earlier studies examined the use of the information from those systems for costing health care services, the methodologies used by hospitals for costing their products or the comparability of the output from the costing methodologies used, thereby making this study different from prior work.
Costing methodologies cited in the literature are described from the perspective of single organisations. This research analyses the development of an aggregated costing approach, focusing on the issues laced when trying to develop a costing methodology that will be applied to a group of autonomous organisations.
The research provides a comparison of health care costing methodologies in both the United Kiiigdom and Ontario, Canada. Collected through interviews and a postal survey tool, data from NHS hospital care providers are analysed to identify both the conformity of the approach and the results of the costing methodologies eniployed. Information from an extended field study is used to review the development of a micro-costing framework in Ontario for radiation therapy services. These findings are then synthesised into a generic framework applicable within other health care organisations seeking to
implement a comparative costing methodology. This lramcwork is used to identify possible causes of variance in health care costing approaches.
Elements of the framework requiring modification to account for local conditions, such as salary rates or provider availability, are identified and suggestions are made for further work resulting from this research to increase understanding about variability in health care costing methodologies and test the implementation of the generic costing methodology.

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