Development and validation of an instrument to measure health-related out-of-pocket costs : the cost for patients questionnaire

Objective: The growth of healthcare spending is a major concern for insurers and governments but also for patients whose health problems may result in costs going beyond direct medical costs. To develop a comprehensive tool to measure direct and indirect costs of a health condition for patients and their families to various outpatient contexts. Methods: We conducted a content and face validation including results of a systematic review to identify the items related to direct and indirect costs for patients or their families and an online Delphi to determine the cost items to retain. We conducted a pilot test-retest with 18 naive participants and analyzed data calculating intraclass correlation and kappa coefficients. Results: An initial list of 34 items was established from the systematic review. Each round of the Delphi panel incorporated feedback from the previous round until a strong consensus was achieved. After 4 rounds of the Delphi to reach consensus on items to be included and wording, the questionnaire had a total of 32 cost items. For the test-retest, kappa coefficients ranged from 20.11 to 1.00 (median = 0.86), and intraclass correlation ranged from 20.02 to 0.99 (median = 0.62). Conclusions: A rigorous process of content and face development was implemented for the Cost for Patients Questionnaire, and this study allowed to set a list of cost elements to be considered from the patient's perspective. Additional research including a test-retest with a larger sample will be part of a subsequent validation strategy

Caractéristiques spermatiques du taureau Baoulé (<em>Bos taurus taurus </em>) au Burkina Faso

Cette étude a porté sur 9 taureaux Baoulé. Une forte incidence pathologique en saison humide perturbe l'ensemble des caractéristiques spermatiques. Ces caractéristiques, pour les animaux sains, sont les suivantes : volume = 2,4 plus ou moins 1,5 ml ; motilité = 3,8 plus ou moins 0,8 ; numération = 1,05 plus ou moins 0,40 10000000/mm3 ; PSI = 80 plus ou moins 23 p. 100 ; anomalies majeures = 3,8 plus ou moins 4,7 p. 100. Il existe une corrélation positive entre l'hygrométrie et les anomalies majeures de la tête et mineures de la tête et de la queue (p < 0,01) et une corrélation positive entre la température maximale et les anomalies majeures de la pièce intermédiaire et de la queue. Les autres caractéristiques spermatiques ne montrent pas de variations saisonnières

Validated tools to measure costs for patients : a systematic review

Background Increasing healthcare expenditures is a major concern to insurers and governments, but also to patients who must pay a greater proportion of their healthcare costs. The objective of this study was to identify validated tools for measuring the costs of a health condition for patients as well as the diferent elements to be considered when measuring costs from the patient's perspective. Methods A systematic literature review was conducted from 1984 to December 2020. The search strategy was applied to seven diferent databases that had been identifed prior as pertinent sources. Two authors independently extracted and compiled data. In case of disagreement, arbitration by two other researchers was conducted. The methodological quality of the included articles was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Results Among the 679 retrieved articles, nine met the inclusion criteria. The types of costs evaluated in these studies included direct costs for patients as well as for caregivers, indirect costs, and intangible costs. The development and validation processes used in these articles included a literature search, a discussion with the involved stakeholders, the development of an initial questionnaire, the testing of the questionnaire on a sample of patients, and a critical review. Regarding the psychometric properties of the tool, only fve studies tested the reliability and validity of the instrument. Conclusions There are very few validated tools available to measure the diferent health-related costs from a patient perspective. Further research is needed to develop and validate a versatile and generalizable tool using a rigorous methodological process