Performance Improvement 2007. How Can Managers and Evaluators Better Understand, Design, and Perform Cost Effectiveness Evaluations of Community Public Health Prevention Programs?



The purpose of this project was to develop a guide stressing the importance of planning for cost effectiveness studies, early in the life of community based prevention programs, for use by program managers and local evaluators.

The Department of Health and Human Services encourages health promotion and disease prevention in a variety of programs targeted to communities. At the community level, managers need to be able to assess whether health promotion and disease prevention interventions are having the desired effect and are a good use of scarce resources. Cost effectiveness analysis is one tool for answering these questions. In cost effectiveness analyses program costs are quantified in dollars and program outcomes are quantified in non-monetary units such as life-years gained. The guide was to offer checklists for the reader, identifying the steps that needed to be taken. It was also to offer advice on how to develop a cost-effectiveness study, including determining the time frame for the intervention and the time frame for the analysis; use of discounting in considering future costs and benefits; and various types of economic studies and their potential use. It also was to offer guidance on identifying outcome measures, citing programs such as the Centers for Disease Control and Prevention's (CDC's) Steps to a Healthier US, and the National Cancer Institute’s American Stop Smoking Intervention Study as examples. It was also to offer criteria for selecting among candidate outcome measures. In a similar vein, it would offer advice on how to quantify program costs, and isolate costs by program component.

Guidance was developed by the contractor, including specific advice on conducting cost-effectiveness analyses, focusing on issues local evaluators are likely to encounter such as how to compare programs that target different health conditions; issues that arise in comparing programs that target the same condition and equity and efficiency concerns. The contractor offered various allocation scenarios that a decision-maker could face and examples of how cost effectiveness studies could inform decision making. The contractor also prepared an annotated bibliography of cost-effectiveness analyses of community prevention strategies from the formal literature as well as worksheets for quantifying program costs.

Report Title: Guide to Analyzing the Cost Effectiveness of Community Public Health Prevention Approaches
Agency Sponsor: ASPE-Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Tilson, Wilma, 202-205-8841
Performer: Research Triangle Institute International; Research Triangle Park, NC
PIC ID: 8483

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"PerformanceImprovement2007.pdf" (pdf, 717.63Kb)

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