Estimating Costs of an Implementation Intervention
Abstract
Health care systems frequently have to decide whether to implement interventions designed to reduce gaps in the quality of care. A lack of information on the cost of these interventions is often cited as a barrier to implementation. In this article, we describe methods for estimating the cost of implementing a complex intervention. We review methods related to the direct measurement of labor, supplies and space, information technology, and research costs. We also discuss several issues that affect cost estimates in implementation studies, including factor prices, fidelity, efficiency and scale of production, distribution, and sunk costs. We examine case studies for stroke and depression, where evidence-based treatments exist and yet gaps in the quality of care remain. Understanding the costs for implementing strategies to reduce these gaps and measuring them consistently will better inform decision makers about an intervention’s likely effect on their budget and the expected costs to implement new interventions.
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The review did not include implementation costs as an outcome because reporting guidelines have not been standardized.
“Further, we did not include implementation costs as an outcome because reporting guidelines have not been standardized [38, 39].”
From A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022 (2024) · cites this paper as [38]
There has been a recent surge of publications related to the collection of costs in implementation science, and emerging consensus regarding the importance of economic influences on implementation outcomes.
“There has been a recent surge of publications related to the collection of costs in implementation science [9, 14, 31, 36], and emerging consensus regarding the importance of economic influences on implementation outcomes (see other articles in this collection).”
From Implementation science issues in understanding, collecting, and using cost estimates: A multi-stakeholder perspective (2021) · cites this paper as [14]
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Self-citation
- Authors
- Wagner, T. H., Yoon, J., Jacobs, J. C., So, A., Kilbourne, A. M., Yu, W., & Goodrich, D. E.
- Affiliations
- VA Palo Alto Health Care System (US)
- United States Department of Veterans Affairs (US)
- Corresponding author
- Wagner, Todd H.
- Venue
- Medical Decision Making
- Publisher
- SAGE Publications
- Published
- 2020-10-20
- Volume
- 40
- Issue
- 8
- Pages
- 959-967
- ISSN
- 0272-989X (ISSN-L)
- 1552-681X
- OpenAlex
- W3092759154
- Cited by
- 59
- References
- 41
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 17 · 2023: 11 · 2022: 14 · 2021: 2
- FWCI
- 7.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Medical Decision Making (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- u.s. department of veterans affairs
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- implementation costs, complex interventions, cost estimation, evidence-based treatment, stroke care, depression treatment, factor prices, fidelity, production scale, sunk costs, information technology costs, health care budgeting
- MeSH terms
- Implementation Science, Cost-Benefit Analysis, Humans, Statistics as Topic
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