title: Assessing costs and potential returns of evidence-based programs for seniors.
abstract: The authors describe the customary tools used by health services researchers to conduct economic evaluations of health interventions. Recognizing the inherent challenges of these tools for utilization in contemporary public health practice, we recommend a practical cost-benefit analysis (PCBA) to allow public health practitioners to assess the economic merits of their existing public health programs. The PCBA estimates what health effects and corresponding medical cost avoidance would be required to support the costs associated with implementing a community-based prevention program. We apply the PCBA to evaluate a statewide evidence-based falls prevention program for seniors in Texas. We estimate a positive return on realized costs due to avoided direct and indirect medical expenses if the program averts 7 falls among 140 participants within the first year. While acknowledging the demonstrated health-related benefits of public health interventions, we provide a practical ex-post economic evaluation methodology to assess return on investment as a more simplistic yet effective alternative for public health practitioners versus contemporary analyses of health services researchers.
authors.affiliation: Department of Health Policy and Management, School of Rural Public Health, Texas A&M Health Science Center, College Station, USA. trmiller@srph.tamhsc.edu
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Miller
authors.forename: Justin B
authors.initials: JB
authors.lastname: Dickerson
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Smith
authors.forename: Marcia G
authors.initials: MG
authors.lastname: Ory
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis / Q000379:methods / Q000706:statistics & numerical data; D055317:Evidence-Based Practice / Q000191:economics* / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures; D006291:Health Policy; D006302:Health Services Research / Q000191:economics / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007449:Investments / Q000191:economics* / Q000706:statistics & numerical data; D018803:Models, Economic; D015233:Models, Statistical; D015397:Program Evaluation / Q000191:economics* / Q000706:statistics & numerical data; D011634:Public Health / Q000191:economics / Q000706:statistics & numerical data; D019057:Quality-Adjusted Life Years; D013781:Texas