Total cost

The total cost of an intervention is the sum of the resources used to deliver that intervention to a specified population over a specified period of time. Which costs are included in the calculation of the total cost depends on whether the analysis is performed from the perspective of society or the healthcare system (Table 1). For example, the total cost of an intervention to the healthcare system would not include costs to society or other sectors of the economy, such as the costs of travelling to the hospital or the loss of work productivity.

Table 1. Healthcare costs that may be included in the calculation of total cost of a health intervention, depending on the perspective from which “total cost” is defined

Cost Payer Perspective
Transport to hospitalPatient or patient’s family

Society if the transport is tax-funded
Society
Reduced productivity at work after surgeryEmployer

Patients
Society
Surgical equipment Purchaser of healthcareHealthcare system
Medication after surgery Purchaser of healthcareHealthcare system
Follow-up visits to the general practitionerPurchaser of healthcareHealthcare system
Salaries of nurses, general practitioners, surgeons, administrative employees Purchaser of healthcareHealthcare system

 Total costs are calculated in market prices. They may also be treated as opportunity costs considering the finite resources of a healthcare system, which means that a shift to one intervention reduces resources available for another.

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