Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis Approach
Background: In 2013, public health moved into Local Authorities, but initial optimism has been overtaken by serious ongoing financial constraints and an uncertain future. Hard choices have become an everyday reality across local authorities and for their public health teams. Assessing the return-on-...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-06-01
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| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fpubh.2019.00147/full |
| _version_ | 1818979951432433664 |
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| author | Lee Robertson Chris Skelly David Phillips |
| author_facet | Lee Robertson Chris Skelly David Phillips |
| author_sort | Lee Robertson |
| collection | DOAJ |
| description | Background: In 2013, public health moved into Local Authorities, but initial optimism has been overtaken by serious ongoing financial constraints and an uncertain future. Hard choices have become an everyday reality across local authorities and for their public health teams. Assessing the return-on-investment of public health interventions and possessing economic evaluation skills have become more critical than ever before.Methods: Using the New Economy cost-benefits-analysis model developed at the Greater Manchester Combined Authority, we undertook cost benefit analyses of some of our largest areas of commissioned spend in local public health practice to better understand both the public and fiscal returns of our interventions.Results: The cost-benefit analyses indicated considerable variation in the public (economic and social) returns-on-investment for our spend on services purchased as a commissioner with £1.37 to 6.81 returned for every £1 spent, and a fiscal return for every £1 invested of between £0.54 and 1.37. Additionally, the fiscal benefits (reduced service costs) of these public health interventions appear to primarily flow to the NHS, which accounts for about 94% of the fiscal return.Conclusion: While cost-benefit modeling cannot provide a complete picture of “value,” it does provide decision-makers with a transparent metric that facilitates a whole-of system discussion on “intervention value” and prevention at scale investments. This approach will support investment strategies when implementing Sustainability and Transformation Partnerships and Integrated Care Systems. However, these tools should be used to support robust decision-making processes, not as a replacement for or a short-circuiting of existing processes. |
| first_indexed | 2024-12-20T17:07:41Z |
| format | Article |
| id | doaj.art-9e7d6deca2e4433ca9c8ae61ed48a028 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-20T17:07:41Z |
| publishDate | 2019-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-9e7d6deca2e4433ca9c8ae61ed48a0282022-12-21T19:32:13ZengFrontiers Media S.A.Frontiers in Public Health2296-25652019-06-01710.3389/fpubh.2019.00147453188Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis ApproachLee RobertsonChris SkellyDavid PhillipsBackground: In 2013, public health moved into Local Authorities, but initial optimism has been overtaken by serious ongoing financial constraints and an uncertain future. Hard choices have become an everyday reality across local authorities and for their public health teams. Assessing the return-on-investment of public health interventions and possessing economic evaluation skills have become more critical than ever before.Methods: Using the New Economy cost-benefits-analysis model developed at the Greater Manchester Combined Authority, we undertook cost benefit analyses of some of our largest areas of commissioned spend in local public health practice to better understand both the public and fiscal returns of our interventions.Results: The cost-benefit analyses indicated considerable variation in the public (economic and social) returns-on-investment for our spend on services purchased as a commissioner with £1.37 to 6.81 returned for every £1 spent, and a fiscal return for every £1 invested of between £0.54 and 1.37. Additionally, the fiscal benefits (reduced service costs) of these public health interventions appear to primarily flow to the NHS, which accounts for about 94% of the fiscal return.Conclusion: While cost-benefit modeling cannot provide a complete picture of “value,” it does provide decision-makers with a transparent metric that facilitates a whole-of system discussion on “intervention value” and prevention at scale investments. This approach will support investment strategies when implementing Sustainability and Transformation Partnerships and Integrated Care Systems. However, these tools should be used to support robust decision-making processes, not as a replacement for or a short-circuiting of existing processes.https://www.frontiersin.org/article/10.3389/fpubh.2019.00147/fulleconomic modeldecision–makingcost benefit analysespublic healthhealth ecomic perspectives |
| spellingShingle | Lee Robertson Chris Skelly David Phillips Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis Approach Frontiers in Public Health economic model decision–making cost benefit analyses public health health ecomic perspectives |
| title | Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis Approach |
| title_full | Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis Approach |
| title_fullStr | Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis Approach |
| title_full_unstemmed | Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis Approach |
| title_short | Making Hard Choices in Local Public Health Spending With a Cost-Benefit Analysis Approach |
| title_sort | making hard choices in local public health spending with a cost benefit analysis approach |
| topic | economic model decision–making cost benefit analyses public health health ecomic perspectives |
| url | https://www.frontiersin.org/article/10.3389/fpubh.2019.00147/full |
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