Quantifying value in public health: Using economic methods to analyze system change

In this time of economic hardship, it is becoming increasingly important for organizations, including those in public health, to ‘prove their worth', to show the value in any improvement strategy. Health agencies have learned to discuss impact in terms of health outcome and mortality/morbidity measures. However, it is critical that these impacts are also expressed in a way that shows cost efficiency and economic benefit for promising, evidence-based public health interventions. Although several methods of economic evaluation including cost effective analysis, cost utility analysis, or cost benefit analysis and return on investment (ROI) have been used in social sciences and health research, fewer examples are found in public health systems research. My research explores common methods for economically quantifying value in public health system change, and these methods will be used to assess cost-benefit in a real-world example: the development of the Center for Community Health (CCH), an academic-public health partnership anchored in the University of Rochester Medical Center (URMC). The University of Rochester has partnered with the Monroe County Department of Public Health to develop the Center for Community Health. The value of the University's investment in public health is quantified through the cost and benefit of the Center, which includes hiring over 70 employees, and successfully negotiating millions of dollars in grants and contracts for public health initiatives. The Center has resulted in several public health improvements that can also be quantified and valued. Public health practitioners and administrators must be held accountable for the resources they use. Academic Medical Centers such as URMC are equally interested in knowing if community health interventions and community engagement initiatives are cost effective. My research is important for equipping practitioners, researchers and administrators with the methods needed to evaluate the cost effectiveness of system interventions.