Delivering the Best to the Most for the Least: Evaluating Resources Used (Costs) by, and Monetary and Nonmonetary Outcomes (Effectiveness, Benefits) of Health and Human Services

Abstract Information: Insights that cost-inclusive evaluation (CIE) generates for evaluators and researchers are illustrated with 50 years of work in health and human services, including child, parent, and adolescent interventions, computer-based drug abuse treatment, consumer-operated mental health services, randomized clinical trials for suicide prevention, and emergency assistance programs for human rights defenders. CIE attempts to understand relationships between program costs and monetary as well as nonmonetary outcomes. CIE works best if conducted using multiple interest group perspectives to collect and analyze data from individual participants for competing interventions and counterfactuals. Common forms of economic evaluation, including cost-effectiveness and cost-benefit analyses, can be most helpful if they go beyond quantifying cost-outcome relationships to understanding resource → activity, activity → process, and process → outcome relationships. Accessible graphic methods of portraying these relationships may encourage engagement of participants, providers, and community members in evaluation and research.