The Role of Economic Evaluation in Dissemination and Implementation Research

Abstract

Abstract Dissemination and implementation (D&I) imposes costs on evidence-based practice (EBP) purveyors, healthcare and promotion organizations, and payers (including governments). Whether these added costs will result in improved service delivery and, ultimately, improvements in recipient outcomes and population health remains an open question. To be of value in informing a D&I decision, an economic evaluation must provide evidence on the impacts of the alternative strategies under consideration on the relevant outcomes, costs, and opportunity costs for the decision maker(s) involved. This requires careful consideration of the decision maker (Who are we informing? What do they care about?); the perspective of the analysis (frame of evaluation); the outcomes; the costs; and the opportunity costs. Further, of utmost importance is the approach to capturing the impact on inequities. If emerging studies reveal that defined D&I strategies are more cost-effective than “usual” approaches, then policymakers and service providers will need to resource these added D&I costs to ensure the success and long-term sustainability of high-quality healthcare and public health activities.