|Equation||(# children) x (Q: % increase in primary care due to the intervention) x (# QALY increase) x ($ QALY)|
|Explanation||This metric estimates the impact of home visiting programs leading to increased primary care access and use on lifetime health, estimated in terms of quality-adjusted life years (QALY). This metric is based on a meta-analysis of the impact of a wide array of home visiting programs including the following: Healthy Families America (HFA), Family Check Up for Children, Nurse-Family Partnership (NFP), Parents as Teachers (PAT), Triple P – Positive Parenting Program®—Variants suitable for home visiting, Family Spirit, Child First, Home Instruction for Parents of Preschool Youngsters (HIPPY), Early Head Start–Home-Based Option (EHS-HBO), Play and Learning Strategies (PALS). These programs serve children from birth through age 17, as well as mothers and expectant mothers.|
Number of children: Reported by program.
Q: Percentage increase in primary care due to the intervention: [1×10-4]. This is estimated by Constellation staff using the following formula:
QALY increase due to treatment: [See table below]. We assume that home visiting may increase the chances of receiving primary care from the age of participation to age 18. The value of one year of access to health care is [0.07 QALY] based in the work of Muennig (2005) and Muennig, Glied & Simon (2005). The following table contains the number of QALYs for assumed or observed average ages of participating children.
$ value per QALY: [$50,000]
Benefits are then discounted to present value based on the average age of participation to life expectancy.
|References||The Commonwealth Fund. (2018). Health Center Data Center. Retrieved from: https://datacenter.commonwealthfund.org/topics/children-medical-and-dental-preventive-care-visit-past-year|
Fergusson, D. M., Grant, H., Horwood, L. J., & Ridder, E. M. (2005). Randomized trial of the early start program of home visitation. Pediatrics, 116(6). https://doi.org/10.1542/peds.2005-0948
Muennig, P. (2005). The cost effectiveness of health insurance. American Journal of Preventive Medicine, 28(1), 59–64.
Muennig, P., Glied, S. & Simon, J. (2005). Estimation of the health benefits produced by Robin Hood Foundation grant recipients. New York, NY: Robin Hood.
Washington State Institute for Public Policy. (2017). Benefit-cost technical documentation. Olympia, WA: Author. Retrieved from: http://www.wsipp.wa.gov/TechnicalDocumentation/WsippBenefitCostTechnicalDocumentation.pdf