A Cost Analysis of a Community Health Worker Program in Rural Vermont

Abstract

Studies have shown that community health workers (CHWs) can improve the effectiveness of health care systems; however, little has been reported about CHW program costs. We examined the costs of a program staffed by three CHWs associated with a small, rural hospital in Vermont. We used a standardized data collection tool to compile cost information from administrative data and personal interviews. We analyzed personnel and operational costs from October 2010 to September 2011. The estimated total program cost was $420,348, a figure comprised of $281,063 (67 %) for personnel and $139,285 (33 %) for operations. CHW salaries and office space were the major cost components. Our cost analysis approach may be adapted by others to conduct cost analyses of their CHW program. Our cost estimates can help inform future economic studies of CHW programs and resource allocation decisions.

Outreach programmes for health improvement of Traveller Communities: a synthesis of evidence

“…Literature from the USA suggests a cost of US $420,000 (based on 2011 figures) per annum to run a team of three, CHWs, of which two-thirds was attributed to staff employment costs and one-third to operational costs. 140 This figure is in line with the estimates of cost reported in this chapter.…”

Understanding cost data collection tools to improve economic evaluations of health interventions

“…Mirambeau et al 28 conducted a cost analysis of a community health worker (CHW) programme for the Northeastern Vermont Regional Hospital service area in rural Vermont and estimated the fixed and variable costs of implementing the programme for 1 year. The researchers created a standardised comprehensive template to collate cost data for 1 year in 2010–2011 from the public health perspective.…”

“…Because data are collected on a micro-level to document the quantities of each resource used, sensitivity analyses can easily be employed to examine how intervention costs could change depending on contextual differences in resource use and resource unit costs 10. For example, costs for inputs such as rent for facilities or certain costs of labour can easily be adjusted to account for potential differences in rents or wages across regions 28. Researchers can also examine cost differences that may result from substituting inputs—such as capital for certain types of labour or using lower cost labour for certain activities—to help optimise efficiency 10 35 36.…”

Strengthening the Effectiveness of State-Level Community Health Worker Initiatives Through Ambulatory Care Partnerships

“…Pilot projects and demonstration projects also have been useful for providing evidence about the effectiveness of CHWs and the cost savings, improved outcomes, and return on investment associated with employing them (Mirambeau et al, 2013; Whitley et al, 2006). Often, such demonstration projects display evaluation methods to assess the effectiveness of CHWs in helping community members manage chronic conditions and use appropriate health services to improve secondary and tertiary care, encourage organizational and managerial commitment to regular monitoring of the cost and outcomes of CHW programs, and model using results to support expansion and continued funding of CHW programs.…”