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The European Journal of Health Economics

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01.02.2013 | Original Paper

A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities

verfasst von: Donal O’Neill, Sinéad McGilloway, Michael Donnelly, Tracey Bywater, Paul Kelly

Erschienen in: The European Journal of Health Economics | Ausgabe 1/2013

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Abstract

Early onset of behavioural problems has lasting negative effects on a broad range of lifetime outcomes, placing large costs on individuals, families and society. A number of researchers and policy makers have argued that early interventions aimed at supporting the family is the most effective way of tackling child behaviour problems. This study forms the economic component of a randomised evaluation of the Incredible Years programme, a programme aimed at improving the skills and parenting strategies of parents of children with conduct problems. Our results show that the programme provides a cost-effective way of reducing behavioural problems. Furthermore, our cost analysis, when combined with a consideration of the potential long-run benefits, suggests that investment in such programmes may generate favourable long-run economic returns.

These relatively small sample sizes reflect the specific nature of the underlying population and are not unusual in studies of this nature (see for example Table 2.3 [37]. In addition, our findings show that the sample sizes we use are sufficient to precisely estimate the key parameters of our model.

We are grateful to Fiachra Bane, CASEMIX/HIPE analyst at the HSE, for providing these figures. More information on the Irish Casemix system can be found at http://www.casemix.ie/.

The estimate is based on a difference-in-difference approach that adjusts for differences in baseline values of the test score.

Comparisons with the general population are difficult though the proportion of the total adult population in Ireland who had visited a GP at least once in the previous 12 months rose from 70.9% in 1987 to 85.6 in 2000 for medical card holders (typically low-income families) and from 52.9 to 66.9 for non-medical card holders [40]. And 16.7% of the adult population had an outpatient visit to a hospital during 2000. The comparative figures for inpatient and A&E visits were 12.9 and 11.8%, respectively [41].

The estimated ICER using compliers only is slightly lower at €76. This reflects a smaller reduction in the ECBI score among the 7 families assigned to the IY intervention but who dropped out before completing the programme.

For reviews of this and other cost-benefit studies, see [37, 43, 44].

This is also close to the mid-point of the range of estimates reported by Koning et al. [10].

Sometimes investments are summarised using net present values (NPV) rather than internal rate of returns. Assuming an opportunity cost of capital of 5%, the NPV of the IY program given our assumptions is €2,927 per child.

Savings due to reduced crime constitute the largest component of many existing cost-benefit analyses of early childhood interventions [15, 47].

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Titel: A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities
verfasst von: Donal O’Neill
Sinéad McGilloway
Michael Donnelly
Tracey Bywater
Paul Kelly
Publikationsdatum: 01.02.2013
Verlag: Springer-Verlag
Erschienen in: The European Journal of Health Economics / Ausgabe 1/2013
Print ISSN: 1618-7598
Elektronische ISSN: 1618-7601
DOI: https://doi.org/10.1007/s10198-011-0342-y

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A cost-effectiveness analysis of the Incredible Years parenting programme in reducing childhood health inequalities

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