Early Years Centres for pre-school children with primary language difficulties: what do they cost, and are they cost-effective?
BACKGROUND
High levels of early language difficulties raise practical issues about the efficient and effective means of meeting children's needs. Persistent language difficulties place significant financial pressures on health and education services. This has led to large investment in intervention in the early years; yet, little is known about the actual and relative costs of early years provision.


OBJECTIVE
To profile the different costs incurred by two Early Years Centres (EYCs) partially funded by the charity I CAN and children receiving what might be termed 'routine' NHS speech therapy to provide an analysis of cost efficiency and equity.


METHODS
Costings for service provision for 91 children (mean age 2;9) were collected. The activity of staff at each site and the cost of staff allocated to services were computed. Data on other resources were also collected.


RESULTS
The cost per child per session was on average 12 pounds. Despite the longer course of intervention in the first centre (10 compared with 6 weeks), the cost of the course per child was of the same order (245 pounds compared with 253 pounds). The annual cost of the early years provision per child was higher relative to the costs of the NHS provision, 645 pounds compared with 181 pounds in one EYC (A) and 462 pounds compared with 173 pounds in the other (B). When the cost of standard nursery provision was factored in, the difference in annual costs was rather less, with 5298 pounds for the early years provision (EYC A) relative to 4276 pounds in the comparison group. By contrast, the annual cost of early provision rises to 5926 pounds relative to 8861 pounds in the comparison group (EYC B).


CONCLUSIONS
The cost of the EYCs is relatively low and given the positive outcomes reported in the study of which this economic evaluation is a part, there is a good case for saying that they represent an efficient use of resources. The strengths and limitations of the economic evaluation are considered and the need for long-term evaluations is highlighted.
Law
J
J
Centre for Integrated Healthcare Research, Queen Margaret's University College, Edinburgh, UK. jlaw@qmuc.ac.uk
Dockrell
J E
JE
Castelnuovo
E
E
Williams
K
K
Seeff
B
B
Normand
C
C
D002662:Child Health Services / Q000191:economics*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006268:Health Facilities / Q000191:economics*; D006801:Humans; D007805:Language Development Disorders / Q000191:economics / Q000628:therapy*; D007808:Language Therapy / Q000191:economics; D008297:Male; D013070:Speech Therapy / Q000191:economics; D013222:State Medicine / Q000191:economics; D006113:United Kingdom