Background Compared with conventional top down costing, micro-costing may provide a more accurate method of resource-use assessment in economic analyses of surgical interventions, but little is known about its current use. The aim of this study was to systematically-review the use of micro-costing in surgery. Methods Comprehensive searches identified complete papers, published in English reporting micro-costing of surgical interventions up to and including 22nd June 2018. Studies were critically appraised using a modified version of the Consensus on Health Economic Criteria (CHEC) Checklist. Study demographics and details of resources identified; methods for measuring and valuing identified resources and any cost-drivers identified in each study were summarised. Results A total of 85 papers were identified. Included studies were mainly observational comparative studies ( n = 42, 49.4%) with few conducted in the context of a randomised trial ( n = 5, 5.9%). The majority of studies were single-centre ( n = 66, 77.6%) and almost half ( n = 40, 47.1%) collected data retrospectively. Only half ( n = 46, 54.1%) self-identified as being ‘micro-costing’ studies. Rationale for the use of micro-costing was most commonly to compare procedures/techniques/processes but over a third were conducted specifically to accurately assess costs and/or identify cost-drivers. The most commonly included resources were personnel costs ( n = 76, 89.4%); materials/disposables ( n = 76, 89.4%) and operating-room costs ( n = 62,72.9%). No single resource was included in all studies. Most studies ( n = 72, 84.7%) identified key cost-drivers for their interventions. Conclusions There is lack of consistency regarding the current use of micro-costing in surgery. Standardising terminology and focusing on identifying and accurately costing key cost-drivers may improve the quality and value of micro-costing in future studies. Trial registration PROSPERO registration CRD42018099604 .

中文翻译：

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微观成本在手术干预经济分析中的应用：系统综述。

背景技术与常规的自上而下的成本计算相比，微观成本计算可能在外科手术干预的经济分析中提供一种更准确的资源使用评估方法，但目前对其用途知之甚少。这项研究的目的是系统地审查微观成本在外科手术中的使用。方法全面搜索确定了完整的论文，并以英文发表，报告了截至2018年6月22日（含）的外科手术的微观成本。研究使用修订版的《健康经济标准共识》（CHEC）清单进行了严格评估。研究人口统计和所查明资源的细节；总结了用于评估和评估已识别资源的方法以及在每个研究中确定的任何成本动因。结果共鉴定出85篇论文。纳入的研究主要是观察性比较研究（n = 42，49.4％），很少在随机试验的背景下进行（n = 5，5.9％）。大多数研究是单中心研究（n = 66，77.6％），几乎一半的研究（n = 40，47.1％）是回顾性收集的数据。只有一半（n = 46，54.1％）自我认定为“微观成本”研究。使用微观成本核算的理由通常是比较程序/技术/过程，但有三分之一以上是专门为准确评估成本和/或确定成本动因而进行的。最常用的资源是人员成本（n = 76，89.4％）；材料/一次性用品（n = 76，占89.4％）和手术室成本（n = 62,72.9％）。所有研究均未包含任何单一资源。大多数研究（n = 72，84.7％）确定了干预的主要成本驱动因素。结论当前在手术中使用微成本计算缺乏一致性。标准化术语并专注于识别和准确计算关键成本动因可能会在未来的研究中提高微观成本的质量和价值。试用注册PROSPERO注册CRD42018099604。