Implementation science issues in understanding, collecting, and using cost estimates: a multi-stakeholder perspective

Implementation Science

Andria B. Eisman¹  Andrew Quanbeck²  Russell E. Glasgow³  Laura Panattoni⁴  Mark Bounthavong⁵ 

[1] Community Health, Division of Kinesiology, Health and Sport Studies, College of Education, Wayne State University, 2153 Faculty/Administration Building, 656 West Kirby, 48202, Detroit, MI, USA;Center for Health and Community Impact (CHCI), Wayne State University, Detroit, MI, USA;Department of Family Medicine and Community Health, University of Wisconsin, Madison, WI, USA;Dissemination and Implementation Science Program of ACCORDS (Adult and Child Consortium for Health Outcomes Research and Delivery Science), University of Colorado School of Medicine, Aurora, CO, USA;Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA;Veterans Administration Health Economics Resource Center and Center, VA Palo Healthcare System, Menlo Park, CA, USA;VA Center for Innovation to Implementation (Ci2i), VA Palo Healthcare System, Menlo Park, CA, USA;UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, San Diego, CA, USA;

关键词: Implementation;    Costs;    Stakeholder;    Perspective;    Decision-making;    Context;    Dissemination;    Health economics;    Sustainment;   

DOI  :  10.1186/s13012-021-01143-x

来源: Springer

【 摘 要 】

Understanding the resources needed to achieve desired implementation and effectiveness outcomes is essential to implementing and sustaining evidence-based practices (EBPs). Despite this frequent observation, cost and economic measurement and reporting are rare, but becoming more frequent in implementation science, and when present is seldom reported from the perspective of multiple stakeholders (e.g., the organization, supervisory team), including those who will ultimately implement and sustain EBPs.Incorporating a multi-level framework is useful for understanding and integrating the perspectives and priorities of the diverse set of stakeholders involved in implementation. Stakeholders across levels, from patients to delivery staff to health systems, experience different economic impacts (costs, benefit, and value) related to EBP implementation and have different perspectives on these issues. Economic theory can aid in understanding multi-level perspectives and approaches to addressing potential conflict across perspectives.This paper provides examples of key cost components especially important to different types of stakeholders. It provides specific guidance and recommendations for cost assessment activities that address the concerns of various stakeholder groups, identifies areas of agreement and conflict in priorities, and outlines theoretically informed approaches to understanding conflicts among stakeholder groups and processes to address them. Involving stakeholders throughout the implementation process and presenting economic information in ways that are clear and meaningful to different stakeholder groups can aid in maximizing benefits within the context of limited resources. We posit that such approaches are vital to advancing economic evaluation in implementation science. Finally, we identify directions for future research and application.Considering a range of stakeholders is critical to informing economic evaluation that will support appropriate decisions about resource allocation across contexts to inform decisions about successful adoption, implementation, and sustainment. Not all perspectives need to be addressed in a given project but identifying and understanding perspectives of multiple groups of key stakeholders including patients and direct implementation staff not often explicitly considered in traditional economic evaluation are needed in implementation research.

【 授权许可】

CC BY