Limits...
Social Return on Investment (SROI) methodology to account for value for money of public health interventions: a systematic review.

Banke-Thomas AO, Madaj B, Charles A, van den Broek N - BMC Public Health (2015)

Bottom Line: However, there remains a lack of consensus on who to include as beneficiaries, how to account for counterfactual and appropriate study-time horizon.Reported SROI ratios vary widely (1.1:1 to 65:1).SROI can be applied across healthcare settings.

View Article: PubMed Central - PubMed

Affiliation: Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK. aduragbemi.banke-thomas@lstmed.ac.uk.

ABSTRACT

Background: Increased scarcity of public resources has led to a concomitant drive to account for value-for-money of interventions. Traditionally, cost-effectiveness, cost-utility and cost-benefit analyses have been used to assess value-for-money of public health interventions. The social return on investment (SROI) methodology has capacity to measure broader socio-economic outcomes, analysing and computing views of multiple stakeholders in a singular monetary ratio. This review provides an overview of SROI application in public health, explores lessons learnt from previous studies and makes recommendations for future SROI application in public health.

Methods: A systematic review of peer-reviewed and grey literature to identify SROI studies published between January 1996 and December 2014 was conducted. All articles describing conduct of public health SROI studies and which reported a SROI ratio were included. An existing 12-point framework was used to assess study quality. Data were extracted using pre-developed codes: SROI type, type of commissioning organisation, study country, public health area in which SROI was conducted, stakeholders included in study, discount rate used, SROI ratio obtained, time horizon of analysis and reported lessons learnt.

Results: 40 SROI studies, of varying quality, including 33 from high-income countries and 7 from low middle-income countries, met the inclusion criteria. SROI application increased since its first use in 2005 until 2011, declining afterwards. SROI has been applied across different public health areas including health promotion (12 studies), mental health (11), sexual and reproductive health (6), child health (4), nutrition (3), healthcare management (2), health education and environmental health (1 each). Qualitative and quantitative methods have been used to gather information for public health SROI studies. However, there remains a lack of consensus on who to include as beneficiaries, how to account for counterfactual and appropriate study-time horizon. Reported SROI ratios vary widely (1.1:1 to 65:1).

Conclusions: SROI can be applied across healthcare settings. Best practices such as analysis involving only beneficiaries (not all stakeholders), providing justification for discount rates used in models, using purchasing power parity equivalents for monetary valuations and incorporating objective designs such as case-control or before-and-after designs for accounting for outcomes will improve robustness of public health SROI studies.

Show MeSH
Stages of the SROI process
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4477315&req=5

Fig1: Stages of the SROI process

Mentions: The SROI framework was first developed by the Roberts Enterprise Development Fund (REDF) in 1996 [10], after which there has been a gradual revision of the original methodology [11]. These revisions have led to an integration of REDF‘s original SROI methodology (a social impact measurement tool) with principles and processes normally used in economic evaluations and financial return on investment to build a framework capable of capturing the wider impact of interventions (social, economic and environmental) [12]. This concept is widely referred to as the “triple bottom line” [13], which is in itself underpinned by the “blended value accounting” theory [14]. Based on the most recent guideline [8], the conduct of a SROI study requires progression through six stages [Fig. 1].Fig. 1


Social Return on Investment (SROI) methodology to account for value for money of public health interventions: a systematic review.

Banke-Thomas AO, Madaj B, Charles A, van den Broek N - BMC Public Health (2015)

Stages of the SROI process
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4477315&req=5

Fig1: Stages of the SROI process
Mentions: The SROI framework was first developed by the Roberts Enterprise Development Fund (REDF) in 1996 [10], after which there has been a gradual revision of the original methodology [11]. These revisions have led to an integration of REDF‘s original SROI methodology (a social impact measurement tool) with principles and processes normally used in economic evaluations and financial return on investment to build a framework capable of capturing the wider impact of interventions (social, economic and environmental) [12]. This concept is widely referred to as the “triple bottom line” [13], which is in itself underpinned by the “blended value accounting” theory [14]. Based on the most recent guideline [8], the conduct of a SROI study requires progression through six stages [Fig. 1].Fig. 1

Bottom Line: However, there remains a lack of consensus on who to include as beneficiaries, how to account for counterfactual and appropriate study-time horizon.Reported SROI ratios vary widely (1.1:1 to 65:1).SROI can be applied across healthcare settings.

View Article: PubMed Central - PubMed

Affiliation: Centre for Maternal and Newborn Health, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK. aduragbemi.banke-thomas@lstmed.ac.uk.

ABSTRACT

Background: Increased scarcity of public resources has led to a concomitant drive to account for value-for-money of interventions. Traditionally, cost-effectiveness, cost-utility and cost-benefit analyses have been used to assess value-for-money of public health interventions. The social return on investment (SROI) methodology has capacity to measure broader socio-economic outcomes, analysing and computing views of multiple stakeholders in a singular monetary ratio. This review provides an overview of SROI application in public health, explores lessons learnt from previous studies and makes recommendations for future SROI application in public health.

Methods: A systematic review of peer-reviewed and grey literature to identify SROI studies published between January 1996 and December 2014 was conducted. All articles describing conduct of public health SROI studies and which reported a SROI ratio were included. An existing 12-point framework was used to assess study quality. Data were extracted using pre-developed codes: SROI type, type of commissioning organisation, study country, public health area in which SROI was conducted, stakeholders included in study, discount rate used, SROI ratio obtained, time horizon of analysis and reported lessons learnt.

Results: 40 SROI studies, of varying quality, including 33 from high-income countries and 7 from low middle-income countries, met the inclusion criteria. SROI application increased since its first use in 2005 until 2011, declining afterwards. SROI has been applied across different public health areas including health promotion (12 studies), mental health (11), sexual and reproductive health (6), child health (4), nutrition (3), healthcare management (2), health education and environmental health (1 each). Qualitative and quantitative methods have been used to gather information for public health SROI studies. However, there remains a lack of consensus on who to include as beneficiaries, how to account for counterfactual and appropriate study-time horizon. Reported SROI ratios vary widely (1.1:1 to 65:1).

Conclusions: SROI can be applied across healthcare settings. Best practices such as analysis involving only beneficiaries (not all stakeholders), providing justification for discount rates used in models, using purchasing power parity equivalents for monetary valuations and incorporating objective designs such as case-control or before-and-after designs for accounting for outcomes will improve robustness of public health SROI studies.

Show MeSH