Objectives
The Investing in Children project at the Dartington Social Research Unit (DSRU) aims to estimate the financial benefits of interventions for children from prevention to treatment and over the child’s lifetime. This project centres around a cost-benefit analysis (CBA) model that utilises evidence from trials of interventions, longitudinal studies of long-term outcomes, and real data on public spending and earnings. It works across four different policy areas – ‘Child protection’, ‘Child and adolescent mental health’, ‘Education’, and ‘Criminal justice’. Its primary objective is to indicate to policy makers or commissioners of children’s services the types of interventions they should invest in for good economic and social returns.
Method
The CBA model is used to forecast the monetary benefits that can be expected over a child’s lifetime if they or their family receive a particular intervention. The DSRU has adapted this model for the UK from the benefit-cost model developed by the Washington State Institute for Public Policy (WSIPP). The starting point in the calculations of benefits is an effect size from all comparative studies of an intervention that meet a quality threshold. To be cautious, potential bias in the studies is addressed by adjusting the effects to estimate what can realistically be expected in real-world implementation in a new context. Failure to do this risks overestimating economic benefits.
The CBA model applies the effect sizes to the base rates of outcomes that can be expected from cohort studies to be found in the relevant populations in the UK, such as crime rates, educational attainment, mental health problems, and out of home placement of children. The amount of change in these outcomes that is expected is then calculated and monetised based on the probability of use and costs of public services, likely effect on earnings, and other relevant monetary effects. The assumptions about the effects on these monetary outcomes are based on real research and data, such as the evidence for how much more people with mental health diagnoses access health services and how much less they are likely to earn in the UK than those without the same diagnoses.
All components of this complex model were considered for relevance to the UK context. The overarching assumptions were maintained, as were some of the actual figures, such as the estimate of programme effect sizes and the links between short- and long-term outcomes for children. For the majority of the model, however, the inputs were replaced to provide forecasts of benefits for the UK.
Results
The results from the CBA model are presented in terms of the benefits to the public sector, to the participant (the child and his/her family), and to society in general. The combination of multiple policy areas facilitates the analysis of interventions across different sectors. It can therefore give an indication of how different sectors might work together. In particular, when an intervention delivered in one sector is found to be likely to save money across multiple sectors, a case can be made for cross-sectoral commissioning.
Conclusions
Over 70 interventions for children have been analysed for this project and the results provide details about the costs and how the benefits accrue for each sector and for participants, the taxpayer, and wider society. The results are presented on a searchable website that allows users to compare interventions for similar populations, policy areas, and target outcomes (http://www.investinginchildren.eu). Details about the methodology and example results will be presented.
Prevention and family intervention programs , Other topics
