Economic Evaluation – Cost-benefit analysis (CBA)

[SOURCE: Glanz A and Knapp M (2017) Understanding substantive and theoretical issues in long-term care. Glossary of key terms. From: Social Protection Investment in Long-Term Care Project, HORIZON 2020 - Grant Agreement No 649565. European Union. (The resource is accessible here)]

Some decision-makers need to decide how to allocate expenditure between social care, education, housing or other interventions, in the hope that available resources can be used to achieve their maximum impact. Until recently, the only outcome measure considered to be appropriate for such broad comparisons (alongside the costs) was monetary: the consequences of the different programmes would need to be converted to monetary values. This type of evaluation is called a cost-benefit analysis (CBA) in health economics contexts. In more general evaluative parlance, the term cost-benefit has also been used in more generic ways (to refer to all types of economic evaluation) as well as in narrower ways (such as when comparing the amount of money expended with the amount that is subsequently saved). Cost-benefit analyses of the conventional variety (with monetary benefits) are generally very difficult to undertake in long-term care contexts, because the most relevant outcomes (such as personal functioning and independence in daily living) are hard to convert into monetary values. Recently, growing attention has been given to the possibility of expressing these common outcomes in terms of a common measure of wellbeing (e.g. the current work of Richard Layard and others at LSE). See also the section on social return on investment below.

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