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Implementation Cost Analysis of an Intensive Comprehensive Aphasia Program

  • Nicole Boyer
    Affiliations
    Department of Medicine, University of Chicago, Chicago, Illinois
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  • Neil Jordan
    Affiliations
    Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

    Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, Illinois
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  • Leora R. Cherney
    Correspondence
    Corresponding author Leora R. Cherney, PhD, Shirley Ryan AbilityLab 25th Floor, 355 E Erie, Chicago, IL 60611.
    Affiliations
    Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

    Center for Aphasia Research and Treatment, Shirley Ryan AbilityLab, Chicago, Illinois
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Published:November 25, 2020DOI:https://doi.org/10.1016/j.apmr.2020.09.398

      Abstract

      Objective

      To identify and measure the costs of implementing an intensive comprehensive aphasia program (ICAP).

      Design

      Retrospective cost analysis of a clinical ICAP. Cost inputs were gathered directly from the provider of the ICAP. We performed several sensitivity analyses to examine major cost drivers and to separate start-up costs from operating costs.

      Setting

      Urban rehabilitation hospital.

      Participants

      Adults with aphasia.

      Main Outcome Measures

      Total implementation cost to the provider.

      Results

      Implementation cost of running the ICAP for the first time was $133,644 for a cohort of 8 participants with aphasia. Break-even charges per participant ranged from $15,278 for 10 participants to $19,700 for 6 participants. After accounting for start-up costs and efficiencies gained, the fourth and subsequent programs were estimated to cost $84,855 each. The majority of the costs were personnel costs, and the cost of the speech language pathologist’s time was the main cost driver in this analysis.

      Conclusions

      Initial implementation costs are high compared with subsequent programs. Future work should examine effectiveness of an ICAP compared with other treatments to determine its cost-effectiveness.

      Keywords

      List of abbreviations:

      ICAP (intensive comprehensive aphasia program), SLP (speech language pathologist)
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