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Evaluating the Cost-Effectiveness of Multi-Outcome Interventions
出版SSRN, 2023
URLhttp://books.google.com.hk/books?id=WXsx0AEACAAJ&hl=&source=gbs_api
註釋Cost-Effectiveness Analysis (CEA) is a widespread method among policymakers due to its intuitive way to estimate the cost of an intervention per unit of outcome improvement. In the case of interventions with multiple outcomes, we show that this standard approach tends to underestimate the programme's efficiency considering that total costs are assessed from a single-outcome perspective and not considering the full range of programme benefits. We propose a method to discount cost-effectiveness ratios (CER) based on multiple benefits, providing a more accurate assessment of interventions with multiple outcomes. Using RCT findings from a violence reduction programme in Liberia, we illustrate the advantages of this discounting approach. For example, a standard CER calculation indicates that $518.2 is the cost to improve in one standard deviation the economic performance z-score among those who received a cash transfer. However, this assessment does not report the simultaneous improvement of 0.3 standard deviations in identity and values, and 0.17 in quality of networks. Our discounting approach shows that $50.1 is the actual cost to improve in one standard deviation the economic performance z-score, once accounting for improvements in the other two outcomes. This example focuses on private benefits to participants so, lower costs are even expected if considering hard-to-measure positive externalities in crime and violence reduction. Accounting for multiple outcomes helps to identify synergies between government sectors, and to compare the efficiency of different interventions achieving similar results.