Wiley Online Library

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A critical review of cost‐effectiveness research in children's social care: What have we learnt so far?
Suh, E., & Holmes, L. 2022

This article presents the findings from a critical review of cost-effectiveness research in children’s social care. With a focus on the past 20 years (since 2000), the review aims to assess the use and consistency of definitions relevant to evaluating cost-effectiveness such as financial input (costs) and outcomes, and to review and summarise learnings from cost-effectiveness studies in the English children’s social care system. We included both academic and grey literature and identified 61 relevant publications for inclusion. The results are organised according to three themes: costs, outcomes and cost-effectiveness. We identified that a large proportion of studies contained a discussion on cost, spend or unit cost, and an equal proportion of articles concerned outcomes of service, benefit to children or quality of service provided. The number of studies discussing cost-effectiveness, cost–benefit or economic evaluation was considerably smaller. The findings highlight substantial gaps in the literature, with a disproportionate focus on stating the problem in terms of cost pressures, and very little robust evidence about cost-effectiveness. Furthermore, the article sets out methodological limitations and indicates a lack of transparency in many of the report studies. We conclude that as a result of the gaps and limitations it is difficult for policymakers and other stakeholders in children’s services to make evidence-informed decisions about the best use of their limited resources.

Research review: Economic evidence for interventions in children's social care: revisiting the what works for children project.
Stevens, M., Roberts, H., & Shiell, A 2010

Evidence about the cost-effectiveness of interventions in children’s services can help decision-makers make more efficient use of scarce resources. We returned to six somewhat disparate interventions on which we had collated research evidence identified by service planners and practitioners as relevant to the well-being of children in the course of the Economic and Social Research Council-funded What Works for Children project. These are home visiting, parenting, cognitive–behavioural therapy, mentoring, traffic calming and breakfast club interventions. We aimed to explore the nature and extent of evidence on cost-benefit and cost effectiveness for these measures. We conducted searches for studies that looked at the costs as well as the effectiveness of the six interventions and found 24 studies matching our inclusion criteria. The studies were diverse in terms of study design and economic methods (including economic modelling and willingness to pay). Studies relating to parenting programmes and traffic calming gave the most positive indication that the interventions may be cost-effective for the outcomes in question. The remainder of the studies did not give a clear picture, in large part because of a lack of demonstration that the intervention was effective.

NIHR School for
Social Care Research