ArticleJournal of general internal medicine2020
Rethinking How We Measure Costs in Implementation Research.
Article in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed.
- Addressing unmet need for substance use disorder treatment among youth in the legal system (YLS): Costs of structured implementation interventions with juvenile justice agencies in seven states.Journal of substance use and addiction treatment · 2025Trial
- Expanding access to colorectal cancer screening through community pharmacies: Study protocol for the PharmFIT™ randomized controlled trial.Contemporary clinical trials · 2026Article
- Evaluating two implementation approaches to support a nationally mandated caregiver skills training in veterans affairs: a type III hybrid implementation-effectiveness randomized controlled trial.Implementation science communications · 2026Article
- A cost analysis of implementing facilitated improvements in hospital palliative care using patient reported experience measures: the LEAHP (Listen Empower Act - Hospital Palliative care) bundle.BMC palliative care · 2026Article
- The Business Case for Family Caregiver Skills Training: Results From a Multisite Trial in the Veterans Health Care System.Journal of the American Medical Directors Association · 2026Article
- Efficiency in health care: connecting economic evaluations with implementation objectives.Implementation science communications · 2025Article
- Challenges and recommendations for collecting and quantifying implementation costs in practice: a qualitative interview study.Implementation science communications · 2024Article
- Assessing and Improving Productivity in Primary Care: Proof of Concept Results for a Novel Value-Based Metric.Journal of general internal medicine · 2024Article
- Budget impact analysis for implementation decision making, planning, and financing.Translational behavioral medicine · 2024Article
- Site-level evidence-based practice accreditation: A qualitative exploration using institutional theory.Human service organizations, management, leadership & governance · 2023Article
- The economics of adaptations to evidence-based practices.Implementation science communications · 2022Article
- Using decision analysis to support implementation planning in research and practice.Implementation science communications · 2022Article
- Extending analytic methods for economic evaluation in implementation science.Implementation science : IS · 2022Article
- Moving beyond Aim Three: a need for a transdisciplinary approach to build capacity for economic evaluations in implementation science.Implementation science communications · 2021Article
- Market viability: a neglected concept in implementation science.Implementation science : IS · 2021Article
- Responding to the Call: a New JGIM Area of Emphasis for Implementation and Quality Improvement Sciences.Journal of general internal medicine · 2020Article
Corrections and comments
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Authors and funding
1 author.
Funding
Abstract
backgroundHospitals and other health care delivery organizations are sometimes resistant to implementing evidence-based programs, citing unknown budgetary implications.
objectiveIn this paper, I discuss challenges when estimating health care costs in implementation research.
designA case study with intensive care units highlights how including fixed costs can cloud a short-term analysis.
participantsNone.
interventionsNone. MAIN MEASURES: Health care costs, charges and payments. KEY
resultsCost data should accurately reflect the opportunity costs for the organization(s) providing care. Opportunity costs are defined as the benefits foregone because the resources were not used in the next best alternative. Because there is no database of opportunity costs, cost studies rely on accounting data, charges, or payments as proxies. Unfortunately, these proxies may not reflect the organization's opportunity costs, especially if the goal is to understand the budgetary impact in the next few years.
conclusionsImplementation researchers should exclude costs that are fixed in the time period of observation because these assets (e.g., space) cannot be used in the next best alternative. In addition, it is common to use costs from accounting databases where we implicitly assume health care providers are uniformly efficient. If providers are not operating efficiently, especially if there is variation in their efficiency, then this can create further problems. Implementation scientists should be judicious in their use of cost estimates from accounting data, otherwise research results can misguide decision makers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.