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Health services accreditation: what is the evidence that the benefits justify the costs?


Mumford, V and Forde, K and Greenfield, D and Hinchcliff, R and Braithwaite, J, Health services accreditation: what is the evidence that the benefits justify the costs?, International Journal for Quality in Health Care, 25, (5) pp. 606-620. ISSN 1353-4505 (2013) [Refereed Article]

Copyright Statement

The Author 2013. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved

DOI: doi:10.1093/intqhc/mzt059


Purpose To identify and analyse research on the use of economic evaluation in health services accreditation. Data sources Seven online health and economic databases, and key accreditation agency and health department websites were searched between June and December 2011. Study selection The 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 extraction Meta-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 synthesis The 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. Conclusion The 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.

Item Details

Item Type:Refereed Article
Keywords:certification/accreditation of hospitals, external quality assessment, economic evaluation (cost effectiveness)
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Greenfield, D (Professor David Greenfield)
ID Code:110816
Year Published:2013
Web of Science® Times Cited:44
Deposited By:TSBE
Deposited On:2016-08-16
Last Modified:2017-11-06

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