Knowing the costs of change: an introduction to health economic analyses and considerations for their use in implementation research

Economic evaluations examine the costs and benefits of health interventions and are commonly used to assist decision makers in the appropriate allocation of health resources. Although considered as an important element for informing knowledge translation, they are yet to be routinely used in implementation research. This tutorial provides an introduction to health economics. It defines the different types of economic analysis including cost-minimization, cost-effectiveness, cost-utility, and cost–benefit analysis. The process of planning and collecting data from a health service and societal perspective is discussed, incorporating cost data (human resources, accommodation, and equipment) and outcome data including health-related quality of life measures. Next, an overview of how this data is used in different types of economic analysis is provided, along with how results can be interpreted to guide decision makers. To provide context, four example studies have been chosen to illustrate the application of these concepts in speech-language pathology research. Finally, the application of health economics in implementation research is discussed. This includes informing the cost of implementation and using economic modelling to examine cost changes when altering an intervention’s conditions or environment. Regardless of the analysis to be undertaken, consultation with a health economist is advised to ensure the evaluation is robust and comprehensive, and that the results disseminated use recommended reporting standards to accurately inform the appropriate allocation of healthcare resources