Micro-Cost Methods for Determining VA Healthcare Costs

摘要

The purpose of this handbook is to introduce researchers to micro-costing, a set of related methods for determining the cost of healthcare. It explains micro-cost methods and provides guidance on using them with data produced by the Department of Veterans Affairs (VA), but many of the principles that are described apply to other healthcare systems. Researchers new to the VA or new to cost analyses often have many questions about institutional matters, and it is these readers we have kept in mind when writing the handbook. We hope it will be a useful reference for more experienced researchers as well. To that end, it will be updated as needed to stay abreast of development in VA data systems and advances in research. The handbook is organized as follows. Chapter 2 provides an overview of datasets that may be used to determine costs of VA care. Two important data sources, the Financial Management System (FMS) and the Cost Distribution Report (CDR), are explored at greater length in chapters 3 and 4, respectively. Chapters 5 through 8 describe three alternative methods of micro-costing: direct observation and measurement (chapter 5), creation of pseudo-bills (chapters 6-7), and statistical cost functions (chapter 8). Chapter 9 covers two topics that have received little attention heretofore: malpractice payments and the cost of capital.