Hi! I’m Brian Yates, co-chair of the Costs, Effectiveness, Benefits, and Economics TIG, founded in 2004. I supervise evaluation theses and dissertations at the Program Evaluation Research Lab (PERL) at American University in Washington DC, in our Clinical Psychology Ph.D. program.
“Cost-effective” doesn’t simply mean “cheap.” “Cost-beneficial” doesn’t simply mean “it’s worth it.” There’s so much more to cost-inclusive evaluation!
Resources are implicit in most theories of change and most program models. Resources and their monetary values (costs) can be made explicit in program models on the “front end” as shown in this figure. Increases in resources available for society (benefits) can be included too, as impacts beyond regular program outcomes.
Evaluations more often get used if they include information on the types, amounts, and monetary values of those ingredients that make programs possible, such as time, space, and telecommunications.
Adding information on improved income for participants, or reductions in their health care and other expenses beyond those of the program, can help advocate for program funding.
Many types of evaluation include costs, from cost feasibility assessments (CFA) and activity-based costing (ABC) through cost-effectiveness analysis (CEA), cost-benefit analysis (CBA), cost-utility analysis (CUA), and social return on investment (SROI). Each can range in complexity from simple to incredibly complex. Simpler usually is better understood and more likely to be used in decisions.
SROI is of increasing interest for many funders: here’s a special issue of an evaluation journal that explores SROI, its applications, and potential problems.
Often my students and I “piggy-back” our cost-inclusive evaluations on regular evaluations, hopefully adding value in exchange for analyzing data on costs, cost-effectiveness, and cost-benefit.
If an evaluation includes a program outcome, and if information is available on the amount of time spent by program implementers, basic cost-effectiveness analysis is possible. If outcomes include changes in use of health care, criminal justice, or other services, a cost-benefit analysis can be conducted.
Like all evaluation, it is essential to include multiple stakeholders in as many steps of cost-inclusive evaluation as possible. For example, when evaluating mental health services, consumers as well as practitioners should be involved from the beginning: “Nothing about me without me”! Consumers as well as practitioners, also need to be asked about the resources they provide. Often consumers’ time spent in sessions and getting to and from clinics exceeds time practitioners spend directly with consumer and indirectly in supervision and case conferences.