10 "Do's" and "Don'ts" for Cost Studies: Lessons learned so far from the COSP MultiSite - PowerPoint PPT Presentation

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10 "Do's" and "Don'ts" for Cost Studies: Lessons learned so far from the COSP MultiSite

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Like outcomes, costs require considerable time and effort to measure well ... Costs can be, and should be, included in research and policy on evidence-based practices! ... – PowerPoint PPT presentation

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Title: 10 "Do's" and "Don'ts" for Cost Studies: Lessons learned so far from the COSP MultiSite


1
10 "Do's" and "Don'ts" for Cost Studies Lessons
learned (so far) from the COSP Multi-Site
  • Brian Yates, Danyelle Mannix, Gazala Ansari,
    Michael Freed
  • American University
  • Washington, DC

2
Cost Study Dos Donts 1 to 5
  • Do treat costs and outcomes similarly
  • Do apply the same scientific criteria to costs
    and outcomes
  • Dont assume that everyone agrees…
  • Do make a distinction between Input Costs and
    Output Costs
  • Do include monetary outcomes in the research plan

3
Cost Study Dos Donts 6 to 10
  • Dont assume program records will capture costs
  • Do include all important costs
  • Dont assume costs are like outcomes in all ways
  • Do fund cost studies adequately!
  • Do get support for the Cost Study

4
1. Do treat costs and outcomes similarly (in
research)
  • Costs deserve the same attention as outcomes
  • Like outcomes, costs require considerable time
    and effort to measure well
  • Costs can be measured and analyzed
    scientifically, too
  • ? Costs can be, and should be, included in
    research and policy on evidence-based practices!

5
2. Do apply the same scientific criteria to costs
and outcomes …
  • Use experimental designs random assignment when
    studying costs
  • Measure costs for each consumer separately
  • Statistically test apparent differences in
  • costs
  • outcomes (effectiveness monetary benefits)
  • cost-effectiveness cost-benefit ratios

6
3. Dont assume everyone agrees…
  • Some would ignore costs entirely
  • Some would wait until outcomes are
    well-researched
  • Some would simplify costs, ignoring some
  • Some assume that all consumers cost the same
    (only average or slot cost)
  • Some would only look at costs, and ignore outcomes

7
4. Do make a distinction between Input Costs
and Output Costs
  • Input Costs
  • the value of resources invested in the program,
    e.g.,
  • providers time
  • consumers time!
  • space, equipment, materials
  • Output Costs
  • costs avoided (cost offset)
  • income produced

8
5. Do include monetary outcomes in research plan
  • Cost savings
  • Health care costs avoided
  • Criminal justice costs avoided
  • Direct benefits
  • Income produced from increased employment
  • Profit from consumer-involved enterprises
  • Monetary outcomes can be derived
  • …from some measures of effectiveness

9
6. Dont assume program records will capture costs
  • Just as you wouldnt assume that program records
    can capture important outcomes
  • Accounting records dont usually capture cost
    data with reliability and validity
  • Program records may record each use
  • …but not the identity of the consumer who used
    the program!
  • Program records may under- or over-estimate
    service use

10
7. Do include all important costs
  • Omitting important outcomes is bad science, but …
  • omitting important costs (and benefits) can alter
    the balance of costs to benefits …
  • … and can reverse policy and funding decisions!

11
Critical Costs to Include
  • Pharmacy
  • Housing
  • Administrative (not just direct costs)
  • The time of …
  • Consumers! (waiting, as well as participating)
  • Family and friends of consumers
  • Providers (providing, waiting for no-shows)
  • Transportation of consumer to site, other

12
Include nonmonetary costs
  • Volunteered and donated resources
  • Critical resources in many COSs, TMHSs
  • Calculate, present costs figures both ways
  • Including volunteered donated resources
  • Excluding volunteered donated resources
  • This is specific case of entertaining multiple
    perspectives on costs
  • …just as there are multiple perspectives on
    outcomes

13
8. Dont assume costs are like outcomes in all
ways…
  • Costs are not a subset of outcomes
  • Dont assume that data collection systems for
    other variables…
  • …can be used for Cost variables as well
  • Costs occur as use occurs
  • Use can be sampled, but perhaps should not be
  • Dont think that research ethics always
    generalize to costs

14
9. Do fund cost studies adequately!
  • Insist that Cost Studies at each site are funded
    adequately
  • e.g., health economist or accountant or
    accounting contact at each site
  • Site contacts should communicate regularly with
    Cost Study director
  • Allow adequate time for cost follow-up
  • e.g., detecting service use following baseline
    interviews may require years of post-baseline
    inquiry with programs

15
10. Get support for the Cost Study!
  • Support from CC Director, POs, Consumers makes or
    breaks the cost study
  • Jean Campbell, Crystal Blyler, Betsy McDonel
    Herr, Zahira Duvall, Janine Elkanich, Bonnie
    Schell, Nancy Erwin
  • Colleagues are essential
  • Jeff Merrill, Matthew Johnsen, Sally Rogers,
    David Lambert, Sarah Diwan
  • Associates are absolutely necessary
  • Danyelle Mannix, Gazala Ansari, Mike Freed

16
For more information
  • Brian T. Yates, Ph.D.
  • Department of Psychology
  • American University
  • 4400 Mass. Ave., N.W.
  • Washington, DC 20016-8062
  • briantyates_at_earthlink.net
  • (please remember to type t between brian and
    yates) Thanks!
  • 202-885-1727
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