International comparability of reference unit costs of education services: when harmonizing methodology is not enough (PECUNIA project)

ABSTRACT

Background

Health problems can lead to costs in the education sector. However, these costs are rarely incorporated in health economic evaluations due to the lack of reference unit costs (RUCs), cost per unit of service, of education services and of validated methods to obtain them. In this study, a standardized unit cost calculation tool developed in the PECUNIA project, the PECUNIA RUC Template for services, was applied to calculate the RUCs of selected education services in five European countries.

Methods

The RUCs of special education services and of educational therapy were calculated using the information collected via an exploratory gray literature search and contact with service providers.

Results

The RUCs of special education services ranged from €55 to €189 per school day. The RUCs of educational therapy ranged from €6 to €25 per contact and from €5 to €35 per day. Variation was observed in the type of input data and measurement unit, among other.

Discussion

The tool helped reduce variability in the RUCs related to costing methodology and gain insights into other aspects that contribute to the variability (e.g. data availability). Further research and efforts to generate high quality input data are required to reduce the variability of the RUCs.

KEYWORDS:

• Economic evaluation
• intersectoral costs and benefits
• PECUNIA
• reference unit costs
• valuation

Acknowledgments

This manuscript was written on behalf of the PECUNIA group. Members of the PECUNIA Group are:

Medical University of Vienna: PI: Judit Simon; team members (in alphabetical order): Michael Berger, Claudia Fischer, Agata Łaszewska, Susanne Mayer, Nataša Perić;

University Medical Center Hamburg-Eppendorf: PI: Hans-Helmut König; team members (in alphabetical order): Christian Brettschneider, Marie Christine Duval, Paul Hinck, Johanna Katharina Hohls, Alexander Konnopka, Louisa-Kristin Muntendorf;

Corvinus University of Budapest: PI: Valentin Brodszky; team members: László Gulácsi;

Maastricht University: PI: Silvia M.A.A. Evers; team members (in alphabetical order): Ruben M.W.A. Drost, Luca M.M. Janssen, Aggie T.G. Paulus, Irina Pokhilenko;

Erasmus University Rotterdam: PI: Leona Hakkaart-van Roijen; team members (in alphabetical order): Kimberley Hubens, Ayesha Sajjad;

Servicio de Evaluación del Canario de la Salud: PI: Pedro Serrano-Aguilar; team members (in alphabetical order): Lidia García-Pérez, Renata Linertová, Lilisbeth Perestelo-Pérez, Cristina Valcárcel-Nazco;

PSICOST Scientific Association: PI: Luis Salvador-Carulla; team members (in alphabetical order):

Nerea Almeda, Pilar Campoy-Muñoz, Carlos R. García-Alonso, Mencía R. Gutiérrez-Colosía, Cristina Romero-López-Alberca;

London School of Economics and Political Science: PI: A-La Park;

University of Bristol: PI: William Hollingworth; team members (in alphabetical order): Sian Noble, Joanna Thorn.

This manuscript was presented and discussed at the lowlands Health Economics Study Group annual conference (lolaHESG) on 27 May 2021 and at the International Health Economics Association (iHEA) conference held in July 12-15, 2021. The co-authors would like to thank the discussant Dr. Brigitte Essers and all others who were present and contributed to the discussion.

Declaration of interest

The author(s) declare that they are partially funded by the PECUNIA Project. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors were involved in the conception and design of the study, as well as the analysis and interpretation of the data. The manuscript was drafted by I Pokhilenko and T Kast. All co-authors were involved in revising the manuscript critically for intellectual content and gave the final approval of the version to be published. All authors agreed to be accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2152331

Additional information

Funding

This study was conducted alongside the ProgrammE in Costing, resource use measurement and outcome valuation for Use in multi-sectoral National and International health economic evaluAtions (PECUNIA), which has received funding from the European Union’s Horizon 2020 research and innovation programme.