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Conference Abstracts

New perspective on social cost-benefit analysis in health care and social welfare. A personalised integrated care approach.

Authors:

Wil van Erp ,

Utrecht University of Applied Sciences, Netherlands, NL
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Winny Schuitemaker

Utrecht University of Applied Sciences, Netherlands, NL
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Abstract

Introduction: Health and social well-being depend on many contextual facets which are interdependent in a complex way and are all but limited to the field of cure and care. Publications of the World Health Organization and the Dutch Ministry of Health show that good health also depends on socioeconomic aspects such as stable living conditions and (pre-emptive) debt counselling.   Inspired by these findings, many programs have been launched that aim for an integrated approach of health and social issues.

Although these programs enjoy a lot of sympathy, the implementation proves to be difficult. Among many obstacles, more than once the financing of the program is a stumbling block. The hesitation to invest is prompted by the uncertainties of the benefits these programs aim at. These uncertainties relate to both size and distribution. The intended results are mostly long term and not always easy to monetize. Moreover, the benefits may distribute among other stakeholders than those who bore the costs of the program, the so-called ‘wrong pocket problem’. To overcome the hesitation to invest, a social cost-benefit analysis offers a remedy.

Social Cost-Benefit Analysis (SCBA): A SCBA assesses the impact of an investment on society by estimating all relevant costs and revenues – both financial and non-financial – and their (re)distributions amongst stakeholders. From this perspective, this type of analysis is an important contribution to policy development. Publications of public planning and research agencies in the Netherlands underline the contribution of SCBA’s to policymaking in the field of public health and social welfare.

Approach: So far, many SCBA’s on health and social welfare issues are drafted from a macro perspective, investigating (inter)national wide mechanisms of action. In these studies, the focus on the individual civilian and corresponding context is underexposed. To overcome this objection, this research proposes to opt for a meso level perspective by performing a SCBA through the lens of a local health care and welfare network and to aim for a context-sensitive application. In this approach, the consecutive research steps are explored in a bottom-up direction, starting with an innovation in a local network and subsequently investigating all possible social cost-benefit effects, including spill-over effects outside the network. In terms of research design, a series of case studies have been conducted.

Findings: So far, the case studies affirm that a SCBA is a convincing tool in the comparative assessments by decision makers. Through the underpinning of the proposed intervention with a SCBA, the proposal is contemplated as more mature. Moreover, several cases show how a SCBA offers welcome arguments in the deliberations with financiers such as health insurance companies and municipalities.

Although the first results look promising, several challenges will have to be taken on. Many cases struggle with the question how to reliably quantify and monetize effects in general and mental welfare effects in particular. Moreover, several cases present the benefits by means of a scenario analysis but fail to substantiate the corresponding probability. Future research is necessary to address these challenges.

 

How to Cite: van Erp W, Schuitemaker W. New perspective on social cost-benefit analysis in health care and social welfare. A personalised integrated care approach.. International Journal of Integrated Care. 2022;22(S3):46. DOI: http://doi.org/10.5334/ijic.ICIC22017
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Published on 04 Nov 2022.

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