What are the best public health investments for local authorities?
PHE ePoster Library. Robertson L. Sep 12, 2017; 186565; 10
Lee Robertson
Lee Robertson
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Abstract Health economics is the study of resource allocation in the face of health sector scarcity, and all resources in the public health and care sector are scarce: money, time, people and technology. Assessing the 'return on investment' of public health interventions is increasingly important in local authority public health decision making. Therefore, the use of economic evaluation methods are more critical than ever before.To estimate the return on investment (ROI) for public health activities across Dorset, Bournemouth and Poole during the period 2013-2016, we identified the amount of work done and the cost associated with five main commissioned programmes: Drugs and Alcohol, LiveWell Dorset, Health Checks, Smokestop and Sexual Health.For each programme we identified, costings, target population, programme reach, compliance and pareto efficiency. We used a standard formula for calculating ROI, and corrected for known economic concepts - deadweight and bias. Additionally, we performed a sensitivity analysis on discounting rates at 0%, 5% and 7%, which showed more uncertainty for the public value ROI.Public Health Dorset spent £36M on these programmes. Over a ten-year period, these activities generated an estimated £90M in economic and wider societal benefits and £22M in fiscal savings. The overall fiscal ROI for these five programmes was £0.62 for every £1 spent. The public value ROI was £2.50 for every £1 spent.The value in reporting on both the fiscal and public returns on investment comes from a need to evaluate immediate financial benefits and the wider and longer-term public benefits of these investments.
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