Health services accreditation: what is the evidence that the benefits justify the costs?
Open Access
- 13 August 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in International Journal for Quality in Health Care
- Vol. 25 (5), 606-620
- https://doi.org/10.1093/intqhc/mzt059
Abstract
PurposeTo identify and analyse research on the use of economic evaluation in health services accreditation.Data sourcesSeven online health and economic databases, and key accreditation agency and health department websites were searched between June and December 2011.Study selectionThe 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 extractionMeta-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 synthesisThe 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.ConclusionThe 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.Keywords
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