Costs to Implement a Pediatric Weight Management Program Across 3 Distinct Contexts

Author:

Smith Natalie Riva12,Simione Meg34,Farrar-Muir Haley3,Granadeno Jazmin3,Moreland Jennifer W.5,Wallace Jessica6,Frost Holly M.789,Young Jackie10,Craddock Cassie11,Sease Kerry1213,Hambidge Simon J.1415,Taveras Elsie M.34,Levy Douglas E.215

Affiliation:

1. Department of Social and Behavioral Sciences, Harvard TH Chan School of Public Health

2. Mongan Institute Health Policy Research Center, Massachusetts General Hospital

3. Division of General Academic Pediatrics, Department of Pediatrics, Mass General for Children

4. Department of Pediatrics, Harvard Medical School, Boston, MA

5. Public Health Institute at Denver Health

6. Department of Family Medicine, Denver Health

7. Department of Pediatrics, Denver Health

8. Center for Health Systems Research, Denver Health, Denver

9. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO

10. Prisma Health

11. Department of Ambulatory Quality and Reliability, Prisma Health

12. Department of Pediatrics, University of South Carolina School of Medicine

13. Prisma Health Children’s Hospital, Greenville, SC

14. Ambulatory Care Services, Denver Health, Denver

15. Harvard Medical School, Boston, MA

Abstract

Background: The Connect for Health program is an evidence-based program that aligns with national recommendations for pediatric weight management and includes clinical decision support, educational handouts, and community resources. As implementation costs are a major driver of program adoption and maintenance decisions, we assessed the costs to implement the Connect for Health program across 3 health systems that primarily serve low-income communities with a high prevalence of childhood obesity. Methods: We used time-driven activity-based costing methods. Each health system (site) developed a process map and a detailed report of all implementation actions taken, aligned with major implementation requirements (eg, electronic health record integration) or strategies (eg, providing clinician training). For each action, sites identified the personnel involved and estimated the time they spent, allowing us to estimate the total costs of implementation and breakdown costs by major implementation activities. Results: Process maps indicated that the program integrated easily into well-child visits. Overall implementation costs ranged from $77,103 (Prisma Health) to $84,954 (Denver Health) to $142,721 (Massachusetts General Hospital). Across implementation activities, setting up the technological aspects of the program was a major driver of costs. Other cost drivers included training, engaging stakeholders, and audit and feedback activities, though there was variability across systems based on organizational context and implementation choices. Conclusions: Our work highlights the major cost drivers of implementing the Connect for Health program. Accounting for context-specific considerations when assessing the costs of implementation is crucial, especially to facilitate accurate projections of implementation costs in future settings.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Public Health, Environmental and Occupational Health

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