scholarly journals Valuing the impact of health and social care programmes using social return on investment analysis: how have academics advanced the methodology? A protocol for a systematic review of peer-reviewed literature

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e022534 ◽  
Author(s):  
Claire Louise Hutchinson ◽  
Angela Berndt ◽  
Susan Gilbert-Hunt ◽  
Stacey George ◽  
Julie Ratcliffe

IntroductionUnlike other forms of evaluation, social return on investment (SROI) methodology offers a way of placing values on personal, social and community outcomes, not just economic outcomes. Developed in 2000, there have been calls for greater academic involvement in development of SROI, which to date has been more typically implemented in-house or by consultants. This protocol describes a systematic review of SROI analysis conducted on health and social care programmes which represent a significant sector of social enterprise internationally. The aims of the systematic review are to (1) identify the extent to which academics have adopted SROI methodology, (2) how academics have interpreted, used and developed SROI methodology and (3) to assess the quality of studies published under peer review.Methods and analysisThe systematic review will include peer-reviewed studies since 2000 published in English. Search terms will be ‘social return on investment’ or ‘SROI’. Health and social care interventions will be identified in the initial screening given the proliferation of possible key words in these areas. Databases to be searched include Web of Science, Scopus, Medline, Social Care Online and National Institute for Health and Care Excellence. Two reviewers will independently conduct initial screening based on titles and abstracts against the inclusion criteria. Data extracted will include date of intervention, country, study design, aim of intervention/programme, participants and setting, health and social care measures used, and SROI ratio. The quality of studies will be assessed by two reviewers using a SROI quality framework designed for the purpose of this study.Ethics and disseminationThe systematic review will review existing published academic literature; as such, ethics approval is not required for this study. A paper of the systematic review will be submitted to a peer-reviewed journal.PROSPERO registration numberCRD42018080195.

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029789 ◽  
Author(s):  
Claire Louise Hutchinson ◽  
Angela Berndt ◽  
Deborah Forsythe ◽  
Susan Gilbert-Hunt ◽  
Stacey George ◽  
...  

ObjectivesTo identify how social return on investment (SROI) analysis—traditionally used by business consultants—has been interpreted, used and innovated by academics in the health and social care sector and to assess the quality of peer-reviewed SROI studies in this sector.DesignSystematic review.SettingsCommunity and residential settings.ParticipantsA wide range of demographic groups and age groups.ResultsThe following databases were searched: Web of Science, Scopus, CINAHL, Econlit, Medline, PsychINFO, Embase, Emerald, Social Care Online and the National Institute for Health and Care Excellence. Limited uptake of SROI methodology by academics was found in the health and social care sector. From 868 papers screened, 8 studies met the criteria for inclusion in this systematic review. Study quality was found to be highly variable, ranging from 38% to 90% based on scores from a purpose-designed quality assessment tool. In general, relatively high consistency and clarity was observed in the reporting of the research question, reasons for using this methodology and justifying the need for the study. However, weaknesses were observed in other areas including justifying stakeholders, reporting sample sizes, undertaking sensitivity analysis and reporting unexpected or negative outcomes. Most papers cited links to additional materials to aid in reporting. There was little evidence that academics had innovated or advanced the methodology beyond that outlined in a much-cited SROI guide.ConclusionAcademics have thus far been slow to adopt SROI methodology in the evaluation of health and social care interventions, and there is little evidence of innovation and development of the methodology. The word count requirements of peer-reviewed journals may make it difficult for authors to be fully transparent about the details of their studies, potentially impacting the quality of reporting in those studies published in these journals.PROSPERO registration numberCRD42018080195.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023464 ◽  
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Breda Naddy ◽  
Andrew O’Regan ◽  
...  

IntroductionFinding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs.Methods and analysisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before–after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.Trial registration numberCRD42018091794.


2014 ◽  
Vol 22 (2) ◽  
pp. 51-61 ◽  
Author(s):  
Catherine Mangan ◽  
Robin Miller ◽  
Jeremy Cooper

Purpose – The purpose of this paper is to explore the relationship between general practitioners (GPs) and social care professionals by reflecting on a project (the Home Truths project) which sought to improve joint working between general practice and social care though an action-research process. Design/methodology/approach – iMPOWER's Home Truths project involved gathering local data regarding joint working in local areas and using this data as a catalyst for change. The Institute of Local Government Studies and the Health Services Management Centre at the University of Birmingham were asked to act as a critical friend to the project. This involved supporting the design of the data collection, offering advice on the process and to carrying out a short evaluation of the impact of the first wave. The paper reflects on the collected data from the sites and information from the impact evaluation. Findings – The paper highlights the poor quality of the relationship between GPs and social workers. Findings that illustrate this include GPs’ poor knowledge of social care services; a perception that social care services were of poor quality and rating the quality of their relationships with social workers as poor. However GPs felt that knowing more about social care could help prevent their patients going into residential care earlier than necessary and wanted to work more closely with social care to exploit the benefits and opportunities. The interventions that have been put in place to try and improve relationships focus on the day-to-day working lives of the professionals rather than attempting to introduce new initiatives. Research limitations/implications – The response rate from GPs in the areas was low (average response rate was 10 per cent in each area) and it may be that only those GPs who are interested in working with social care responded. The initiatives that have been developed appear to be reasonable responses to the issues identified. However, a lack of discrete outcomes through which to measure improvement will make it difficult to demonstrate the impact of the interventions. Originality/value – This paper underlines that despite many years of policy makers promoting better integration, the relationship between the key gate-keepers within the health and social care systems is still poor. The findings from the Home Truths surveys and action plans has gone some way to address the gap identified in the evidence base about the relationships between GPs and social workers.


2012 ◽  
Vol 17 (5) ◽  
pp. 637-650 ◽  
Author(s):  
Jo Brett ◽  
Sophie Staniszewska ◽  
Carole Mockford ◽  
Sandra Herron-Marx ◽  
John Hughes ◽  
...  

2021 ◽  
Author(s):  
Ping-Jen Chen ◽  
Lisanne Smits ◽  
Rose Miranda ◽  
Jung-Yu Liao ◽  
Irene Petersen ◽  
...  

Abstract Background: Home healthcare (HHC) may reduce acute hospital utilization, but its effect on homebound people living with dementia (PLWD) at end-of-life remains unclear. We aim to describe the impact of HHC on acute healthcare utilization and end-of-life outcomes in PLWD.Methods: Design: A systematic review of quantitative and qualitative studies regarding the association between HHC (exposure) and targeted outcomes. Interventions: HHC provided by health care professionals, including physicians or nurses. Participants: At least 80% of study participants had dementia and lived at home. Measurements: Primary outcome was acute healthcare utilization in the last year of life. Secondary outcomes included palliative care use, advance care planning (ACP), continuity of care in the last year of life, and place of death. We identified contextual information about policy changes in HHC for these outcomes.Results: We included five studies from USA, Japan, and Italy, none of which received a high-quality rating. At micro-level, HHC may be associated with a lower risk of acute healthcare utilization in the early period (e.g., last 90 days before death) and a higher risk in the late period (e.g. last 15 days) of the disease trajectory toward end-of-life in PLWD. ACP with written decisions may be an important mediator of this. HHC increases referrals to palliative care. At meso-level, HHC providers’ difficulty in making treatment decisions for PLWD at the end-of-life may require further training and external support. Coordination between HHC and social care is mentioned but not well examined in the existing literature.Conclusions: The review highlights the dearth of dementia-specific research regarding the impact of HHC on end-of-life outcomes. In PLWD, the core components of HHC for achieving better quality end-of-life, the integration between health and social care, and coordination between primary HHC and palliative care should be further investigated in future studies.


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019296 ◽  
Author(s):  
Helen Elsey ◽  
Tracey Farragher ◽  
Sandy Tubeuf ◽  
Rachel Bragg ◽  
Marjolein Elings ◽  
...  

ObjectivesTo assess the feasibility of conducting a cost-effectiveness study of using care farms (CFs) to improve quality of life and reduce reoffending among offenders undertaking community orders (COs). To pilot questionnaires to assess quality of life, connection to nature, lifestyle behaviours, health and social-care use. To assess recruitment and retention at 6 months and feasibility of data linkage to Police National Computer (PNC) reconvictions data and data held by probation services.DesignPilot study using questionnaires to assess quality of life, individually linked to police and probation data.SettingThe pilot study was conducted in three probation service regions in England. Each site included a CF and at least one comparator CO project. CFs are working farms used with a range of clients, including offenders, for therapeutic purposes. The three CFs included one aquaponics and horticulture social enterprise, a religious charity focusing on horticulture and a family-run cattle farm. Comparator projects included sorting secondhand clothes and activities to address alcohol misuse and anger management.ParticipantsWe recruited 134 adults (over 18) serving COs in England, 29% female.Results52% of participants completed follow-up questionnaires. Privatisation of UK probation trusts in 2014 negatively impacted on recruitment and retention. Linkage to PNC data was a more successful means of follow-up, with 90% consenting to access their probation and PNC data. Collection of health and social-care costs and quality-adjusted life year derivation were feasible. Propensity score adjustment provided a viable comparison method despite differences between comparators. We found worse health and higher reoffending risk among CF participants due to allocation of challenging offenders to CFs, making risk of reoffending a confounder.ConclusionsRecruitment would be feasible in a more stable probation environment. Follow-up was challenging; however, assessing reconvictions from PNC data is feasible and a potential primary outcome for future studies.


Author(s):  
Dragana Vidovic ◽  
Gina Yannitell Reinhardt ◽  
Clare Hammerton

Social prescribing programmes (SP) are person-centred coaching schemes meant to help participants improve individual circumstances, thereby to reduce demand on health and social care. SP could be an innovative means to improve preventive and public health in the pursuit of universal financially sustainable healthcare. Given its potential, our systematic review assesses type, content, and quality of evidence available regarding SP effectiveness at the individual, system, and community levels. We examine the impact of SP on addressing loneliness, social isolation, well-being, and connectedness, as well as related concepts, which are not yet considered jointly in one study. Following PRISMA, we search: EBSCOHost (CINAHL Complete; eBook Collection; E-Journals; MEDLINE Full Text; Open Dissertations; PsycARTICLES; PsycINFO); Web of Science Core Collection; and UK National Institute for Health and Care Excellence. Excluding systematic reviews and articles without impact evaluations, we review 51 studies. Several studies do not distinguish between core concepts and/or provide information on the measures used to assess outcomes; exactly one peer-reviewed study presents a randomised controlled trial. If we wish to know the potential of social prescribing to lead to universal financially sustainable healthcare, we urge researchers and practitioners to standardise definitions and metrics, and to explore conceptual linkages between social prescribing and system/community outcomes.


Author(s):  
Tessa Peasgood ◽  
Clara Mukuria ◽  
Jill Carlton ◽  
Janice Connell ◽  
Nancy Devlin ◽  
...  

AbstractEconomic evaluation combines costs and benefits to support decision-making when assessing new interventions using preference-based measures to measure and value benefits in health or health-related quality of life. These health-focused instruments have limited ability to capture wider impacts on informal carers or outcomes in other sectors such as social care. Sector-specific instruments can be used but this is problematic when the impact of an intervention straddles different sectors.An alternative approach is to develop a generic preference-based measure that is sufficiently broad to capture important cross-sector outcomes. We consider the options for the selection of domains for a cross-sector generic measure including how to identify domains, who should provide information on the domains and how this should be framed. Beyond domain identification, considerations of criteria and stakeholder needs are also identified.This paper sets out the case for an approach that relies on the voice of patients, social care users and informal carers as the main source of domains and describes how the approach was operationalised in the ‘Extending the QALY’ project which developed the new measure, the EQ-HWB (EQ health and wellbeing instrument). We conclude by discussing the strengths and limitations of this approach. The new measure should be sufficiently generic to be used to consistently evaluate health and social care interventions, yet also sensitive enough to pick up important changes in quality of life in patients, social care users and carers.


Sign in / Sign up

Export Citation Format

Share Document