HEU, Centre for Health Economics

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Costing and Assessment of Health Services and Programmes


The HEU has collaborated with national, regional and international agencies to conduct research in various areas. 

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Featured Research


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Costing of Health Services and Programmes

These studies include the collection of financial, utilization and other relevant data from public health care institutions to estimate the average and total costs of procedures and treatment episodes.  An assessment of the efficiency of the particular health facility is also undertaken. Some of the information generated includes the average cost of an inpatient day at a medical/surgical ward, the average cost of an outpatient clinic, the average cost of a surgical procedure, and the average cost of a diagnostic service such as an ultra sound or a lab test. The data generated from these costing exercises provide critical insight for (i) implementing cost control strategies; (ii) justifying budgetary allocation to facilities and (iii) facilitating the understanding of the critical relationship between throughput and level of expenditure. 

Costing studies have been carried out in Trinidad and Tobago, St. Lucia, Barbados, Jamaica, St. Vincent and the Grenadines, Grenada, St. Kitts and Nevis, Antigua and Barbuda, British Virgin Islands.





  • The Costing of Health Services in Trinidad and Tobago, Volume I: Port of Spain General Hospital, St. Ann’s Psychiatric Hospital, Oxford Street Enhanced Health Centre.

  • The Costing of Health Services in Trinidad and Tobago, Volume II: Siparia District Health Facility, Trinidad Public Health Laboratory, National Blood Transfusion Service, Community Hospital of Seventh Day Adventists.

  • The Costing of Health Services in Trinidad and Tobago, Volume III: Scarborough Health Centre, Scarborough General Hospital, Eric Williams Medical Sciences Complex, Wendy Fitzwilliam Paediatric Hospital, Dental Hospital Augustus Long Hospital.

  • The Costing of Health Services in Trinidad and Tobago: National Costing of Health Services.

  • The Costing of Health Services in Trinidad and Tobago, Assessment Report Volume I: A Review of the Preparedness of Hospitals in Trinidad and Tobago to Implement a Cost-Centre Based Accounting System.

  • The Costing of Health Services in Trinidad and Tobago, Assessment Report Volume II: A Review of the Preparedness of Hospitals in Trinidad and Tobago to Implement a Cost-Centre Based Accounting System.



Total and Average costs for services are being provided for the following health facilities:

  • Queen Elizabeth Hospital (QEH);

  • Psychiatric Hospital;

  • Albert Graham Centre;

  • Elayne Scantlebury Centre;

  • St. Michael’s Geriatric Hospital;

  • St. Philip District Hospital;

  • Gordon Cummins District Hospital;

  • St. Lucy District Hospital; and

  • Nine Polyclinics - David Thompson Polyclinic, Winston Scott Polyclinic, Eunice Gibson Polyclinic, Maurice Byer Polyclinic, Randal Phillips Polyclinic, St. Philip Polyclinic, Branford Taitt Polyclinic, Edgar Cochrane Polyclinic, and Glebe Polyclinic.



The Cost of Hospital Services in St. Lucia: Turning Point Alcohol and Drug Detoxification Rehabilitation Centre, Mental Wellness Centre, St. Jude Hospital, Victoria Hospital, New National Hospital.


Towards a Health System that Reflects the Values and Preferences of the Trinidad and Tobago Population.

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This research was funded by the Ministry of Health of Trinidad and Tobago.  Resource allocation decision-making in the health system of Trinidad and Tobago can be greatly enhanced by the introduction of cost per quality adjusted life year (QALY) analysis based on local preferences.  The objective of this project was to create an EQ-5D-3L value set for Trinidad and Tobago using an elicitation method that takes into account the local constraints.  Internationally, Cost Utility Analysis (CUA) dominates economic evaluation in health and the EQ-5D descriptive system is the most commonly used basis for making the quality adjustments in CUA.  The existence of a local value set based on the EQ-5D system will greatly facilitate the work in this area.  


Evaluation of the Efficiency and Effectiveness of the Maternal, Neonatal, Child and Adolescent Health Care Services in Trinidad and Tobago


This Study was funded by the PAHO.  The purpose of this research was to evaluate the efficiency and effectiveness of the maternal, neonatal, child and adolescent health care services in Trinidad and Tobago and promote their improvement.  An assessment of these services was carried out using the Maternal, Neonatal, Child Health and Adolescent (MNCAH) tool, which rated functional components under Stewardship, Adequate and Sustainable Resources, and Health Service Delivery.  This assessment informed the suite of activities elaborated in both the 2014-2015 United Nations Development Assistance Framework (UNDAF) and the project document ‘Improving maternal, infant and child health through quality interventions in Trinidad and Tobago.


An Economic Approach to Costing Diabetes in the Caribbean.   


This study was funded by The University of the West Indies’ Ford Foundation Grant.  The goal of this project was to prepare the empirical groundwork for the application of a user-friendly methodology to estimate the economic impact of diabetes in the Caribbean.  In this first phase two health facilities located in the North West Health Region in Trinidad—the Arima Health Facility which is a district hospital, and the Oxford Street Health Centre.  The results of this phase of the study were important building blocks in the overall estimation in producing a robust estimate of the economic cost of diabetes in the region. 


Identifying a Financing System and a Costing Framework for the Health System of Trinidad and Tobago. 

The Cost and Financing Sub-Committee of the Implementation Steering Committee, Trinidad and Tobago.  The research was part of a Ministry of Health/ IDB project that aimed to provide a clearly articulated framework for the costing of services being financed in the public sector.  The report provided the Ministry of Health with information on health financing mechanisms, specifically a National Health Insurance System.  The analysis also identified gaps in existing national health insurance system proposals and developed terms of reference for the development and implementation of health service cost management and health services financing systems.  A project-titled report was produced and submitted.

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