Assessing the Costs and Benefits of HIA

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Assessing the Costs and Benefits of HIA

• Jacqueline OReilly, YHEC
• Cardiff, 6 April 2006

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Presentation Overview

• Motivation
• Evaluation of HIA
• Methods

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Motivation

• Increasing HIA interest and activity
• Emphasis on value for money
• Wanless Review, NICE
• Opportunity cost of undertaking HIA
• Pressure on finance for front-line services
• Resources could be deployed elsewhere
• Do the benefits of HIA justify the costs?

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Evaluation of HIA
Process evaluation What activities were
undertaken? How? By whom?
Impact evaluation Impact on decision-making
process
Outcome evaluation Impact on public health
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Previous Evaluations

• Previous HIA evaluations
• HDA
• London Mayoral Strategies
• Alconbury Airbase
• Finningley Airport
• Focus on process evaluation
• Methods

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Cost Benefit Analysis

• Concurrent study of HIAs
• Process
• End-of-stage surveys
• Review of documentation
• Resource use and costs
• Benefits

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Resource Use Cost

• Direct costs
• Time input from HIA team
• Weekly timesheets
• Wage rates from Annual Survey of Hours and
  Earnings
• Indirect costs
• External consultants, venue hire
• Resource log

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Benefits of HIA
Process benefits Community engagement Awareness
of health and its wider determinants
Impact benefits Informing and influencing
decision making
Outcome benefits Recommendations to maximise
positive, and minimise negative, health effects
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Identification of Benefits of HIA
Process benefits
Interviews with decision makers and stakeholders
Impact benefits
Outcome benefits
Quantification of health effects
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Valuation of Benefits

• Problems
• Quasi willingness-to-pay approach
• How much do you value the benefits gained from
  HIA, relative to ?
• Hypothetical, costed alternatives
• Specific to PCTs and LAs
• Affected by scope of HIA

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Conclusions

• Previous studies evaluated HIA process
• Assessment using cost benefit analysis
• Especially difficult to quantify benefits
• Credence to HIA

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