Implementation Cost Analysis of an Intensive Comprehensive Aphasia Program

  • Nicole Boyer
    Department of Medicine, University of Chicago, Chicago, Illinois
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  • Neil Jordan
    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
    Corresponding author Leora R. Cherney, PhD, Shirley Ryan AbilityLab 25th Floor, 355 E Erie, Chicago, IL 60611.
    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:



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


      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.


      Urban rehabilitation hospital.


      Adults with aphasia.

      Main Outcome Measures

      Total implementation cost to the provider.


      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.


      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.


      List of abbreviations:

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