Communicating Value in Simulation: Cost Benefit Analysis and Return on Investment

Abstract

Value-based health care requires a balancing of medical outcomes with economic value. Administrators need to understand both the clinical and economic effects of potentially expensive simulation programs to rationalize the costs. Given the often-disparate priorities of clinical educators relative to health care administrators, justifying the value of simulation requires the use of economic analyses few physicians have been trained to conduct. Clinical educators need to be able to present thorough economic analyses demonstrating returns on investment and cost effectiveness to effectively communicate with administrators. At the 2017 Academic Emergency Medicine Consensus Conference "Catalyzing System Change through Health Care Simulation: Systems, Competency, and Outcomes", our breakout session critically evaluated the cost benefit and return on investment of simulation. In this paper we provide an overview of some of the economic tools that a clinician may use to present the value of simulation training to financial officers and other administrators in the economic terms they understand. We also define three themes as a call to action for research related to cost benefit analysis in simulation as well as four specific research questions that will help guide educators and hospital leadership to make decisions on the value of simulation for their system or program. This article is protected by copyright. All rights reserved.

Cost evaluations in health professions education: a systematic review of methods and reporting quality

“…Reviewers and authors of cost evaluations may consider using the modified MERSQI definitions developed in this review as a starting point for improving the quality of measuring cost (Appendix ). More broadly, researchers looking to develop the field of cost evaluation research in HPE may consider relevant guidance from already established work in HPE, as well as in health economics and education economics …”

Factors Affecting Implementation of Simulation-Based Education After Faculty Training in a Low-Resource Setting

“…Information about the costs involved in simulation-based medical education is sparse. [23][24][25] A good balance can be achieved between the efforts spent on simulation-based education and the expectation of returns by curricular mapping and integration. 14,26 This strategy will ensure that simulation-based training is not a standalone, time-, and resource-consuming activity but an evidence-based, mandatory methodology to improve patient safety and outcomes.…”

“…Currently, there is limited evidence of return on investment with regard to simulation-based training, particularly in low-resource settings. Information about the costs involved in simulation-based medical education is sparse 23–25 . A good balance can be achieved between the efforts spent on simulation-based education and the expectation of returns by curricular mapping and integration 14,26 .…”

Recomendaciones generales para elaborar un programa de entrenamiento basado en simulación para desarrollar competencias en pregrado y postgrado

“…Por esto, es importante comunicar a los administradores el impacto clínico y económico de programas de simulación potencialmente costosos para justificar su existencia y racionalizar los costos. 66 Una forma de hacerlo es mediante el cálculo de costos asociados a error y/o complicaciones potencialmente mejorables mediante entrena-www.medigraphic.org.mx miento, en comparación con el costo de implementación de un programa de simulación. El método exacto mediante el que se realiza un análisis de costos se encuentra en la literatura y excede los objetivos del presente artículo.…”

“…El método exacto mediante el que se realiza un análisis de costos se encuentra en la literatura y excede los objetivos del presente artículo. 66 A modo de ejemplo, un entrenamiento para inserción de catéter venoso central basado en simulación realizado en una Unidad de Cuidados Intensivos previno alrededor de 10 casos de infección asociada a catéter vascular (IACV) el primer año. El gasto promedio asociado con cada evento de IACV se avaluó en aproximadamente 82,000 USD.…”