title: What are the benefits and risks of using return on investment to defend public health programs?
abstract: Return on investment (ROI) is an economic measure used to indicate how much economic benefit is derived from a program in relation to its costs. Interest in the use of ROI in public health has grown substantially over recent years. Given its potential influence on resource allocation, it is crucial to understand the benefits and the risks of using ROI to defend public health programs. In this paper, we explore those benefits and risks. We present two recent examples of ROI use in public health in the United States and Canada and conclude with a series of proposals to minimize the risks associated with using ROI to defend public health interventions.
authors.affiliation: Canada Research Chair in Evaluation and Health System Improvement, Community Health Sciences Department, Centre de recherche de l'Hôpital Charles LeMoyne, Université de Sherbrooke, Canada.
authors.forename: Astrid
authors.initials: A
authors.lastname: Brousselle
authors.affiliation: Institute for Health and Social Policy, McGill University, Canada.
authors.forename: Tarik
authors.initials: T
authors.lastname: Benmarhnia
authors.affiliation: Centre de recherche de l'Hôpital Charles LeMoyne, Programme des sciences cliniques, Université de Sherbrooke, Canada.
authors.forename: Lynda
authors.initials: L
authors.lastname: Benhadj
keywords: Economic evaluation; Public health; Return on investment; Savings