Measuring Costs to Community-Based Agencies for Implementation of an Evidence-Based Practice.
Healthcare reform has led to an increase in dissemination of evidence-based practices. Cost is frequently cited as a significant yet rarely studied barrier to dissemination of evidence-based practices and the associated improvements in quality of care. This study describes an approach to measuring the incremental, unreimbursed costs in staff time and direct costs to community-based clinics implementing an evidence-based practice through participating in a learning collaborative. Initial implementation costs exceeding those for providing "treatment as usual" were collected for ten clinics implementing trauma-focused cognitive behavioral therapy through participation in 10-month learning collaboratives. Incremental implementation costs of these ten community-based clinic teams averaged the equivalent of US$89,575 (US$ 2012). The most costly activities were training, supervision, preparation time, and implementation team meetings. Recommendations are made for further research on implementation costs, dissemination of evidence-based practices, and implications for researchers and policy makers.
Child Health and Development Institute, 270 Farmington Ave., Suite 367, Farmington, CT, 06032, USA. jalang@uchc.edu.|Department of Psychiatry, UCONN Health Center, Farmington, CT, USA. jalang@uchc.edu.|Child Study Center, Yale School of Medicine, New Haven, CT, USA. jalang@uchc.edu.
Jason M
JM
Lang
The Consultation Center, Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT, USA.
Christian M
CM
Connell
D000554:Ambulatory Care Facilities / Q000191:economics*; D015928:Cognitive Behavioral Therapy; D003365:Costs and Cost Analysis; D055317:Evidence-Based Practice / Q000191:economics*; D011320:Primary Health Care; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology