Micro-Costing in Public Health Economics: Steps Towards a Standardized Framework, Using the Incredible Years Toddler Parenting Program as a Worked Example
Micro-Costing in Public Health Economics: Steps Towards a Standardized Framework, Using the Incredible Years Toddler Parenting Program as a Worked Example
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DOI：
10.1007/s11121-012-0302-5
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发表时间：
2013-08-01
影响因子：
3.5
通讯作者：
Hutchings, J.
中科院分区：
文献类型：
--
作者：
Charles, J. M.;Edwards, R. T.;Hutchings, J.
复杂的干预措施，如育儿计划，很少从公共部门，多机构的角度进行评估。一个例外是不可思议的岁月（IY）基本育儿计划;它有一个越来越多的临床和成本效益的证据基础，以防止或减少儿童的行为问题。本文的目的是提供一个微成本计算框架，供未来的研究人员使用，从公共部门，多机构的角度微观成本计算的12届国际幼儿年幼儿养育计划。这项微成本计算是在英国威尔士贫困的“飞行起步”地区进行的一项基于社区的随机对照试验的一部分。项目交付成本由组长成本日记收集。记录了培训和监督费用。敏感性分析评估了伦敦成本加权和集团规模的影响。2008/2009年度费用以英镑列报。直接方案的初始设立费用为3305.73澳元;该方案磅经常性交付费用为每名儿童752.63磅，根据10名父母计算，下降到633.61磅。在研究背景下（每周监督），分娩成本为1509.28磅，每个孩子基于8个父母，下降到1238.94英镑，每个孩子基于10个父母。当应用伦敦加权时，所有情况下的总体计划成本都增加了。必须准确计算微观一级的成本，以便进行有意义的成本效益/成本效益分析。需要一个评估成本的标准化框架;本文件概述了一个建议的框架。在预防科学中，决策者必须了解干预成本，以便有效分配稀缺资源。
Complex interventions, such as parenting programs, are rarely evaluated from a public sector, multi-agency perspective. An exception is the Incredible Years (IY) Basic Parenting Program; which has a growing clinical and cost-effectiveness evidence base for preventing or reducing children's conduct problems. The aim of this paper was to provide a micro-costing framework for use by future researchers, by micro-costing the 12-session IY Toddler Parenting Program from a public sector, multi-agency perspective. This micro-costing was undertaken as part of a community-based randomized controlled trial of the program in disadvantaged Flying Start areas in Wales, U.K. Program delivery costs were collected by group leader cost diaries. Training and supervision costs were recorded. Sensitivity analysis assessed the effects of a London cost weighting and group size. Costs were reported in 2008/2009 pounds sterling. Direct program initial set-up costs were A 3305.73; pound recurrent delivery costs for the program based on eight parents attending a group were A 752.63 pound per child, falling to A 633.61 pound based on 10 parents. Under research contexts (with weekly supervision) delivery costs were A 1509.28 pound per child based on eight parents, falling to A 1238.94 pound per child based on 10 parents. When applying a London weighting, overall program costs increased in all contexts. Costs at a micro-level must be accurately calculated to conduct meaningful cost-effectiveness/cost-benefit analysis. A standardized framework for assessing costs is needed; this paper outlines a suggested framework. In prevention science it is important for decision makers to be aware of intervention costs in order to allocate scarce resources effectively.