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Table 4 Resource use (costs) to be collected.

From: Protocol for an economic evaluation alongside the University Health Network Whiplash Intervention Trial: cost-effectiveness of education and activation, a rehabilitation program, and the legislated standard of care for acute whiplash injury in Ontario

Costs Examples
Health care provider fees Initial assessment, follow-up visits.
Fees for completing standardized automobile insurance claims forms Treatment Plan (OCF-18), Discharge and Status Report (OCF-24).
Health services (block fees) In-home assessment, functional evaluation, job site assessment, home exercise prescription, multidisciplinary evaluation, workplace/home modification assessment, home exercise prescription, multidisciplinary evaluation, workplace/home/vehicle modification assessment, return to work support, education programs, life skills and job retraining, counseling and coaching, stress management, relaxation therapy, family counseling, cognitive behavioral therapy, pain management.
Patient out-of-pocket expenses Over-the-counter medications, prescription drugs, portable electrotherapy devices, orthotics, assistive devices, health care supplies, treatment-related expenses.
Diagnostic imaging Radiography, magnetic resonance imaging, ultrasound.
Benefits Non-earner, dependent care, caregiver, housekeeping and home maintenance, income replacement, attendant care, lost educational expenses, expense of visitors, long-term care, excess economic loss.
Independent health examination Chiropractic, medical, occupational therapy, physical therapy, psychological.
  1. OCF = Ontario Claim Form