S L Rahn | PubMed Health

PubMed1996

Third generation information systems: integrating costs and outcomes. Tools for professional development and program evaluation.

The authors present specific procedures for obtaining cost per closed case and a case outcome rating for each closed case, computer generated, yielding a cost-outcome report for single cases and aggregated cases. The procedures are illustrated with field data from an alcohol and drug addiction service. Cost per closed case is seen as the new unit cost datum. Combined with case outcome information, the cost-outcome report is seen as a promising new measure of efficiency. The potential of the cost-outcome report as a new basis for professional self-development, increased treatment effectiveness, and program evaluation is discussed.

Budgets↗

PubMed1986

Funding human services: fixed utility versus fixed budget.

It is argued in this paper that government allocations for human services based on inputs rather than outcomes, reduce efficiency in social and health service provision. An alternative system of budgeting or contracting on the basis of cost-per-closed case and case outcome is discussed. An interdependency between fixed budget and fixed utility models of allocation is affirmed. The locus of decision-making for operationalizing this interdependency is seen as the program and budget review panel to which operating agencies and government departments must submit financial and program accounting information from year to year. In isolation, the fixed budget approach degenerates into routine allocation or contract renewal with a focus on such input and output variables as volume of service and unit cost, and the fixed utility approach, into political stalemate. Simulated examples are given to demonstrate how allocation on the basis of inputs and outputs alone provides an incentive to inefficiency, and a fixed utility orientation to efficiency.

Budgets↗