TY - JOUR
T1 - Health services accreditation
T2 - what is the evidence that the benefits justify the costs?
AU - Mumford, Virginia
AU - Forde, Kevin
AU - Greenfield, David
AU - Hinchcliff, Reece
AU - Braithwaite, Jeffrey
PY - 2013/10
Y1 - 2013/10
N2 - Purpose. To identify and analyse research on the use of economic evaluation in health services accreditation. Data sources. Seven online health and economic databases, and key accreditation agency and health department websites were searched between June and December 2011. Study selection. The selection criteria were English language and published empirical research studies on the topic of economic evaluation of health service accreditation. No formal economic evaluation of health services accreditation has been carried out to date. Empirical data on costs and benefits were analysed in 6 and 15 studies, respectively. Data extraction. Meta-analysis was unsuitable due to output variability. Attributes relating to study design, scalability and independence of outcome data were collected. For the benefit studies, we also assessed the strength of claim that accreditation improved patient safety and quality, and sources of potential bias. Results of data synthesis. The incremental costs ranged from 0.2 to 1.7% of total costs averaged over the accreditation cycle. The benefit studies were inconclusive in terms of showing clear evidence that accreditation improves patient safety and quality of care. Conclusion. The lack of formal economic appraisal makes it difficult to evaluate accreditation in comparison to other methods to improve patient safety and quality of care. The lack of a clear relationship between accreditation and the outcomes measured in the benefit studies makes it difficult to design and conduct such appraisals without a more robust and explicit understanding of the costs and benefits involved.
AB - Purpose. To identify and analyse research on the use of economic evaluation in health services accreditation. Data sources. Seven online health and economic databases, and key accreditation agency and health department websites were searched between June and December 2011. Study selection. The selection criteria were English language and published empirical research studies on the topic of economic evaluation of health service accreditation. No formal economic evaluation of health services accreditation has been carried out to date. Empirical data on costs and benefits were analysed in 6 and 15 studies, respectively. Data extraction. Meta-analysis was unsuitable due to output variability. Attributes relating to study design, scalability and independence of outcome data were collected. For the benefit studies, we also assessed the strength of claim that accreditation improved patient safety and quality, and sources of potential bias. Results of data synthesis. The incremental costs ranged from 0.2 to 1.7% of total costs averaged over the accreditation cycle. The benefit studies were inconclusive in terms of showing clear evidence that accreditation improves patient safety and quality of care. Conclusion. The lack of formal economic appraisal makes it difficult to evaluate accreditation in comparison to other methods to improve patient safety and quality of care. The lack of a clear relationship between accreditation and the outcomes measured in the benefit studies makes it difficult to design and conduct such appraisals without a more robust and explicit understanding of the costs and benefits involved.
UR - http://www.scopus.com/inward/record.url?scp=84885163362&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/arc/LP100200586
UR - http://purl.org/au-research/grants/nhmrc/568612
U2 - 10.1093/intqhc/mzt059
DO - 10.1093/intqhc/mzt059
M3 - Article
C2 - 23942825
AN - SCOPUS:84885163362
VL - 25
SP - 606
EP - 620
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
SN - 1464-3677
IS - 5
M1 - mzt059
ER -