Table 5.

Differences between accounting cost and economic evaluation approach.

Source: own elaboration

	Health service provider. Accounting cost	Health economist. Economic evaluation	Example
Source of data	Retrospective/historical data	Synthesis data from different sources to predict future costs of relevant treatment options	UK reference costs are published with 2-year lag
Objective	Financial reporting management	Opportunity cost of providing service	Hospitals are obliged to estimate costs using a specific methodology and using a standard report format
Time horizon and fixed costs	Short run total mean cost	Long run marginal cost	Providers may not distinguished between fixed and variable costs
Perspective	Single organizational perspective	System-wide or societal perspective	Providers only include items recorded in their accounting ledger. E.g., in some countries may not include depreciation or financing costs
Practical constraints	Lack of resources to undertake detailed micro-costing	Wish to include all relevant resources	Health service providers may not have the IT systems or personnel available to conduct detailed micro-costing