Social Return on Investment from an asthma community-based case management intervention program

Objective: A Social Return on Investment (SROI) analysis rather than a conventional cost-benefit analysis was conducted for the Community Asthma Initiative (CAI) program. SROI enables us to account for all the impact the program has at the payer, hospital, and especially at community levels.

Methods: The SROI for the program is based on the post intervention two year savings in hospital costs associated with lower emergency room visits and inpatient stays, and reductions in missed school days for patients and missed workdays for parents/caregivers. The Net Present Value (NPV) of the program is calculated as the difference of the Present Value of benefits and program costs, and the SROI as the ratio of the Present Value of benefits and program costs.

Results: An expenditure of $268,887 was incurred in 2006 for 97 CAI patients with a Present Value of $254,871. The hospital cost savings of ER visits and hospitalizations in years one and two after enrollment were $157,192 and $213,966 respectively. The imputed value of cost savings per year from reduction of missed school days and missed work days amounted to $11,392 and $10,602 respectively. The NPV of the investment from the project is $117,434 and the SROI is 1.46.

Conclusion: Investment in the CAI program has been repaid within just two years resulting in a net benefit of $117,434. The SROI of 1.46 shows a very high return from the program. If we consider the same benefits over a longer period, the actual SROI would be higher than 1.46.