Research Matrix
Cost Benefit: Thirteen published studies were identified which dealt with cost, cost-effectiveness or “return on investment” in CHW activities. Only two of these studies dealt with cost-related measures as a principal topic of the published articles.
| Lead Author | Year | Health Issue | Outcome Measures | Cost Measures |
Barnes-Boyd |
2001 |
Infant mortality reduction |
Mortality rates, program retention, health problems identified, immunization rates |
Implied cost saving potential in that outcomes with nurse-CHW team at least equal to those of nurse-only team (no calculations) |
Beckham |
2004 |
Asthma management |
Reported symptoms, doctor visits, ED visits |
Total per capita costs reduced from $310 to $129; ED costs reduced from $1,119 per participant to $188 |
Black |
1995 |
Failure to thrive (NOFTT) |
Child development measures, parent-child interaction scores |
Costs of intervention “generally consistent with” other home-visiting programs ($1,709-6,200 per year) |
Brown |
2001 |
Diabetes self-management |
Blood measures, health beliefs, diabetes knowledge |
Cost of intervention $384 per person per year |
Fedder |
2003 |
Diabetes management |
ED visits, hospital admissions, quality-of-life indicators |
Cost to Medicaid reduced an average of $2,245 per patient per year |
Krieger |
2000 |
Older adult flu and pneumonia prevention |
Immunization rates |
Marginal cost per additional vaccine administered = $117; options for lower cost discussed |
Krieger |
2005 |
Asthma (indoor triggers) |
Caregiver quality of life; use of urgent health services; symptom days |
Projected four-year net savings $189-721 per participant |
Margolis |
1998 |
Breast, cervical cancer screening |
Screening rates |
Marginal cost per additional exam estimated at $700-750 |
Rodewald |
1999 |
Childhood immunizations |
Immunization rates |
Marginal cost per additional immunization administered = $474. Each $1,000 in program costs also produced additional preventive and other primary care office visits |
Sox |
1999 |
Cancer screenings for women |
Effectiveness of trained Community Health Aides performing clinical exams and Pap smears (Alaska) |
Implied cost saving in reduced travel of clinical personnel to remote villages (no calculations) |
Weber |
1997 |
Mammography |
Rates of mammography use |
Marginal cost of CHW activity per additional mammography performed = $375, equivalent to $11,591 per year of life saved |
Whitley |
2006 |
Primary care utilization |
Utilization, charges and reimbursements |
Cost reduction of $14,244 per month, program cost of $6,229 per month = ROI ratio of 2.28:1 |
Wolff |
1997 |
Mental illness |
Treatment contact, psychiatric symptoms, satisfaction with treatment |
Total cost of treatment less with CHW but not statistically significant: treatment only, $49,510; treatment with CHW team, $39,913; brokered case management, $45,076 |
Anne Willaert
Healthcare Education Industry Partnership
507.389.2590
anne.willaert@mnsu.edu