Elsevier

Psychiatry Research

Volume 283, January 2020, 112433
Psychiatry Research

Economic evaluation in implementation science: Making the business case for implementation strategies

https://doi.org/10.1016/j.psychres.2019.06.008Get rights and content
Under a Creative Commons license
open access

Highlights

  • Economic considerations influence implementation of evidence-based mental health practices.

  • Decision makers and other stakeholders need cost information to make implementation decisions.

  • Economic evaluation of implementation strategies differs from traditional economic evaluation.

  • Economic evaluation of implementation is critical for efficient use of organizational resources.

Abstract

Implementation researchers have made notable progress in developing and testing implementation strategies (i.e., highly-specified methods used to help providers improve uptake of mental health evidence-based practices: EBPs). Yet, implementation strategies are not widely applied in healthcare organizations to improve delivery of EBPs. Economic considerations are a key factor influencing the use of implementation strategies to deliver and sustain mental health evidence-based practices, in part because many health care leaders are reluctant to invest in ongoing implementation strategy support without knowing the return-on-investment. Comparative economic evaluation of implementation strategies provides critical information for payers, policymakers, and providers to make informed decisions if specific strategies are an efficient use of scarce organizational resources. Currently, few implementation studies include implementation cost data and even fewer conduct comparative economic analyses of implementation strategies. This summary will introduce clinicians, researchers and other health professionals to the economic evaluation in implementation science. We provide an overview of different economic evaluation methods, discuss differences between economic evaluation in health services and implementation science. We also highlight approaches and frameworks to guide economic evaluation of implementation, provide an example for a cognitive-behavioral therapy program and discuss recommendations.

Keywords

Implementation science
Cost-effectiveness analysis
Cost-benefit analysis
Economic evaluation
Evidence-based practice
Community mental health services

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