Table 1 Key cost considerations mapped to perspectives, priorities, and stage of implementation for different types of stakeholders
Stakeholder perspective | Key priorities | Example pre-implementation costs | Example implementation costs | Example sustainability costs |
|---|---|---|---|---|
Policy and economic environment | Incentivize most cost-effective actions; maximize QALYSa | Current market (e.g., capacity, needs assessment); gaps in quality of care | Direct costs (e.g., labor, supplies); factor prices, (fidelity, production scale, distribution, sunk costs); downstream costs [14] | Can provide less reimbursement; consider other incentives; maximize/optimize staff resources |
Organization | Stay within budget; align with the mission | Capital expenses; costs of promotion and recruitment; health information technology (e.g., dashboard development) | Time until recoup investments; return on investment (ROI) [15] | Costs to maintain quality service (e.g., labor; technology support/maintenance) |
Management team: supervisory staff | Effective allocation of staff; efficient workflow, maximizing outcomes given budget constraints | Training costs; infrastructure development | Costs to produce quality results; documenting and logging time and effort | Retraining costs; cost audit and feedback; budget constraints |
Provider team: front line delivery staff | Improve workflow; competing demands; relative benefit of adopting new EBP (time and productivity/outcomes) | Opportunity costs for training, logistics, and preparation for EBP adoption | Time required (e.g., documenting and logging time and effort) | Opportunity costs for ongoing support activities, training; incentives |
Individual participant/patient | Improved health outcomes; competing demand; satisfaction; reduce out of pocket expenses | Travel and time costs; opportunity costs; information costs | Time required on regular basis; | Adherence costs; incentives |