Cost Measurement in Evaluations of
Prevention Programs for Children *
Eric Slade, Ph.D.
University of Maryland, School of Medicine and the Johns
Hopkins Univ. Center for Prevention and Early Intervention
October 28, 2005
* Financial support for this presentation was provided
by NIMH Grant No. P30MH066247
Statement of the Problem
• The reported costs of different programs
often are not directly comparable.
– Differences in methods used.
– Differences in reporting.
• High comparability of cost estimates across
programs/interventions is obviously
desirable.
– How much would it actually cost? To whom?
Overview
• Examples
• 7 Recommendations for Good Practice
Example 1: Implicit Time Costs
• Program A is nurse home visiting; program
B is school-based mediation skills.
• Suppose A could be implemented at lower
monetary cost than B, but is it less costly?
– A’s protocol specifies parenting training
sessions 5 hours/week for up to 6 weeks.
– B does not require parent involvement, but
does require students complete homework.
Example 1: Implicit Time Costs
• How much time did parents contribute to
each program?
• What is the economic value of their time?
– Depends on parents’ opportunity costs – not
zero.
– In principle, would be valued by the min.
monetary inducement required to ensure their
participation in the program.
Example 2: Capital Expenses
• Program B requires use of a classroom 5
hours per week for 9 months.
– Participating schools donated space at no cost
to the program.
– Explicit valuation of the space is essential.
• Not doing so would make B look artificially cheap.
• Could use rental cost for similar space OR depreciation plus
foregone investment return.
Example 3: Related Expenses
• Program A resulted in additional trips to
primary care providers by case managers
and parents.
– Program B did not involve any services beyond
the intervention.
• May assign value to each trip, but may or
may not include the costs of the primary
care visits.
Recommendations
1. Need a professional consensus statement on
standards for reporting costs.
– Prior to then, report technical specifications.
2. All resources utilized by a program or whose
rate of use is influenced by the program should
be assigned costs.
3. When theoretical perspective on cost is
potentially ambiguous (e.g., societal versus the
public cost) report two sets of measures.
Recommendations
4. Report both total costs and costs per hour
(or minute) per participant.
5. Report setup, operating, and follow-up
costs separately, and state how setup
costs were distributed to the program.
6. Discuss impacts of any assumptions
about cost offsets.
e.g., Programs A & B could both prevent school
disciplinary events.
Recommendations
7. Conduct sensitivity analyses on unit prices
and probabilities adopted from external
sources (e.g., special education costs).
For More Information
See E. Michael Foster’s website:
www.unc.edu/~emfoster
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