Connecting delivery costs with the account of results

Research question

Comparing interventions requires more than a funding total. An economic assessment needs to identify the resources used, the outcomes examined, the period of observation and the perspective from which costs are counted.

Source and findings

Efficiency is one of the OECD evaluation criteria, alongside effectiveness, impact and other dimensions. It should not be treated as interchangeable with the amount spent. OECD, Evaluation criteria

Interpretation

Efficiency analysis needs defined costs, outcomes and a perspective. Time released for other work is not necessarily a cash saving.

What a comparison needs to disclose

Two interventions reporting similar outcomes may rely on different staffing, donated inputs or temporary technical support. A financial expenditure statement can omit resources supplied by other organisations. An economic analysis needs a transparent treatment of those contributions and a clear description of which resources belong to the intervention being assessed.

The outcome denominator also matters. Cost per service contact answers a different question from cost per sustained improvement. A comparison should explain its time horizon and how differences in delivery context affect interpretation. Sensitivity analysis can show how conclusions depend on uncertain assumptions. These are analytical considerations for designing a study, not a finding that an intervention is inefficient merely because its reported unit cost is higher.

Limits of the evidence

This brief sets out analytical considerations. It reports no original costing study or estimate of waste.