COST-OUTCOME AND COST-EFFECTIVENESS ANALYSIS - EMERGING EVALUATION TECHNIQUES (FROM EVALUATING COMMUNITY MENTAL HEALTH SERVICES - PRINCIPLE AND PRACTICE, 1977, BY ISABEL DAVIDOFF ET AL - SEE NCJ-52043)

• NCJ Number: 52050
• Author(s): J E SORENSEN; H D GROVE
• Date Published: 1977
• Length: 21 pages
• Corporate Author: US Dept of Health, Education, and Welfare; US Dept of Health, Education, and Welfare; National Institute of Mental Health
• Sale Source: National Institute of Justice/
• Language: English
• Country: United States of America

Annotation

THE PROBLEMS OF DETERMINING COST EFFECTIVENESS IN NONPROFIT SERVICE ORGANIZATIONS ARE IDENTIFIED, OUTCOME MEASURES ARE DISCUSSED, FOLLOWED BY THE APPLICATION OF COST-OUTCOME AND EFFECTIVENESS TECHNIQUES TO AN EXAMPLE.

Abstract

THE TRADITIONAL PROGRAM-PLANNING-BUDGETING SYSTEMS AND COST-BENEFIT ANALYSES APPLIED TO PROFIT-MAKING ENTERPRISES ARE INDICATED TO BE INAPPLICABLE TO NONPROFIT SERVICE PROGRAMS BECAUSE OUTCOME IS A NONMONETARY FACTOR. ONE OF THE CENTRAL PROBLEMS IN DETERMINING THE COST-EFFECTIVENESS OF NONPROFIT ENTERPRISES IS THE MEASUREMENT OF OUTCOMES OF PARTICULAR DOLLAR AND TREATMENT INPUTS. THE FOLLOWING ASPECTS OF OUTCOME MEASUREMENT ARE BRIEFLY ANALYZED: TIME PATTERNS, MULTIPLE OUTCOMES, EFFECTS AMONG DIFFERENT POPULATIONS, SIMPLE VERSUS COMPLEX EVALUATIONS, AND RESEARCH DESIGN QUESTIONS. SPECIFIC COST-OUTCOME AND COST-EFFECTIVENESS EVALUATION TECHNIQUES ARE DEVELOPED AND APPLIED TO A MENTAL HEALTH EXAMPLE. AN ACTIVITY FLOW CHART FOR HUMAN SERVICE PERFORMANCE EVALUATION SUGGESTS DESIRED SERVICE ACTIVITIES TO BE DELIVERED TO TARGET GROUPS IN THREE TIME FRAMES. THE OUTPUT MEASURES ARE MADE BY THE MENTAL HEALTH PROFESSIONALS WHO DETERMINE THE DEGREE OF CLIENT IMPAIRMENT AT SUCCESSIVE POINTS IN TIME. THE PATIENTS ARE RATED ON FOUR CRITERIA: PERSONAL SELF-CARE, SOCIAL FUNCTIONING, VOCATIONAL AND/OR EDUCATIONAL FUNCTIONING, AND EVIDENCE OF EMOTIONAL STABILITY AND/OR STRESS TOLERANCE. THESE FOUR CRITERIA ARE USED TO RATE THE PATIENTS ON A NINE-POINT ORDINAL SCALE. FINAL DETERMINATION OF RATINGS FOR EACH CLIENT IS BASED ON CONSENSUS AMONG THE PROFESSIONAL EVALUATORS. COST DATA ARE ACCUMULATED BY DETERMINING THE VARIETY OF SERVICES PROVIDED TO A TARGET GROUP FOR WHICH OUTCOME RESULTS HAVE BEEN DETERMINED AND THEN ASSESSING THE COSTS OF THESE SERVICES. THE COST-OUTCOME MATTERS DEALT WITH IN THIS APPROACH ARE INDICATED. THE COST-EFFECTIVENESS MATRIX AIMS AT DETERMINING THAT THE TREATMENT MEASURES FOR WHICH COST IS KNOWN ARE IN FACT RESPONSIBLE FOR THE OUTCOMES MEASURED. IT IS SUGGESTED THAT THIS CAN BEST BE DONE BY THE USE OF A CONTROL GROUP THAT DOES NOT RECEIVE THE SERVICES PROVIDED TO THE TARGET GROUP. BY COMPARISON OF TWO OR MORE COST-OUTCOME STATEMENTS, THE EFFECTIVENESS OF COSTS FOR ACHIEVEMENT OF PROGRAMS, MODALITIES, OR TECHNIQUES CAN BE ASSESSED. FIGURES, TABULAR DATA, AND REFERENCES ARE INCLUDED.