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Estimating Downstream Budget Impacts in Implementation Research.

Health care decision makers often request information showing how a new treatment or intervention will affect their budget (i.e., a budget impact analysis; BIA). In this article, we present key topics for considering how to measure downstream health care costs, a key component of the BIA, when imple...

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Published in:Medical Decision Making Vol. 40; no. 8; pp. 968 - 978
Main Authors: Wagner, Todd H., Dopp, Alex R., Gold, Heather T.
Format: review tables/charts Journal Article
Published: Sage Publications Inc. Nov2020
Online Access:View this record in EBSCOhost
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      dt: Nov2020
      vid: 40
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: Estimating Downstream Budget Impacts in Implementation Research.
      aug:
        au:
          Wagner, Todd H.
          Dopp, Alex R.
          Gold, Heather T.
        affil: Department of Surgery, Stanford University, Stanford, CA
      sug:
        subj:
          Budgets
          Implementation Science Economics
          Costs and Cost Analysis
          Health Care Costs
          Medical Practice, Evidence-Based
          Health Resource Utilization
          Decision Making
          Financial Management
      ab: Health care decision makers often request information showing how a new treatment or intervention will affect their budget (i.e., a budget impact analysis; BIA). In this article, we present key topics for considering how to measure downstream health care costs, a key component of the BIA, when implementing an evidence-based program designed to reduce a quality gap. Tracking health care utilization can be done with administrative or self-reported data, but estimating costs for these utilization data raises 2 issues that are often overlooked in implementation science. The first issue has to do with applicability: are the cost estimates applicable to the health care system that is implementing the quality improvement program? We often use national cost estimates or average payments, without considering whether these cost estimates are appropriate. Second, we need to determine the decision maker's time horizon to identify the costs that vary in that time horizon. If the BIA takes a short-term time horizon, then we should focus on costs that vary in the short run and exclude costs that are fixed over this time. BIA is an increasingly popular tool for health care decision makers interested in understanding the financial effect of implementing an evidence-based program. Without careful consideration of some key conceptual issues, we run the risk of misleading decision makers when presenting results from implementation studies.
      pubtype: Academic Journal
      doctype:
        review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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