Embed Size (px)
Citation preview
Evaluating Services & Expenditure in Social SectorsApproaches supported by The Atlantic Philanthropies
Gail BirkbeckFeb 1, 2013
2
o Introduction to The Atlantic Philanthropies
o Evaluation at Atlantic
o Some examples
Overview
3
o Atlantic has made grants to advance opportunity and lasting change for those who are unfairly disadvantaged or vulnerable to life's circumstances.
o A limited life foundation, we make grants through our Ageing, Children & Youth, Population Health and Reconciliation & Human Rights Programmes.
o We are active in Bermuda, Northern Ireland, Republic of Ireland, South Africa, the United States and Viet Nam.
o We have made grants totalling over $6.1billion
o At the heart of our work is the belief that all people have the right to opportunity, equity and dignity.
About Atlantic
4
o Informing strategy and implementation
o Assessing impact and context
o To enhance capacity, facilitate learning and share knowledge
Evaluation and Learning - Purpose
5
o Grounded in questions critical to understanding effects and impact
o A ranges of methods are used
o Different level of analyses – individual, community, programme, Atlantic, philanthropy
o Some approaches are more helpful in the early development stage, others more suited to ongoing programmes, others still where information is needed quickly
Evaluation Design and Approaches
6
Children & Youth Programme
Promote Prevention & early intervention
o Demonstrate effective practice leading to policy reform
o Inform and influence policy and practice
o Develop capacity & infrastructure for the sector
International trends towards increasing emphasis on prevention strategies to cost-effectively address social problems
April 21, 2023
April 21, 2023
9
April 21, 2023
April 21, 2023
12
o Selecting services based on the evidence of specific community needs
o Selecting services models or interventions with evidence of effectiveness
o Testing their effectiveness in local communities
Evidence-based Service Design
13
o Significantly improves teachers’ competencies and their management of disruptive behaviours in the classroom.
o Benefits pupil behaviour and socio-emotional adjustment.
o Reductions in child conduct disordered and hyperactive-type behaviour.
o In total, 71 per cent of children showed improvements in behaviour.
o Parents reported reduced distress and improved well-being.
o Substantial decline at follow-up in the use of primary care and social work services in the intervention group
Incredible Years - RCT of Teacher Classroom Management and Parent Training programmes.
14
Sample (n=103)
Service Baseline 6 month follow-up 12 month follow-up
GP 65 49 40
Nurse 8 5 2
Speech Therapist 24 15 9
Physiotherapist
Social Worker
6
10
2
1
3
2
Community paediatrician 5 3 0
SNA 11 11 13
Casualty department (A & E) 15 14 11
Outpatient consultant appointment 22 14 16
Overnight stay in hospital 7 8 6
Service UtilisationProportion (%) using health and social care services at baseline and follow-up
12 Month Follow-On Report (IY Parent Teacher Programmes) McGilloway et al. 2012
Positive changes in child and parenting behaviour were maintained at followup in the context of reduced support from primary health care and social care services.
15
Cost Analysis
Calculating Costs of Individual Services
oUnit costs for key services identified in the SUQ was collected
oCost of service use at the 12-month follow-up (€626.91) amongst the intervention group was reduced to 60% of baseline expenditure on formal services (€1047.91).
Cost per child at baseline and follow-up (ITT)
oPrimary Care €158.55 - €68.61
oHospital Services €453.50 - €166.18
oSpecial Education €428.13 - €386.36
A cost-effectiveness analysis of the Incredible Years Parenting Programme in Reducing Health Inequalities ; O’Neill et al (2013)
16
o Ireland – Comprehensive Review of Expenditure (DCYA, 2011), detail on expenditure but does not account for Health expenditure
o US - Urban Institute releases an annual report on child expenditure
o 2011 federal expenditures rose overall but fell for children from 10 to 8%
o UK - LSE reports on public expenditure on children in the UK - 'The way in which budgets are currently constructed across the UK makes it very difficult to identify what is actually spent on children…‘
o Trends - education, social security & social services
Spending is being tracked although not connected to outcomes
Accessing Cost Data
17
Palliative Care
oA systematic review of palliative care
oPatterns & Costs of deaths in Ireland
oCost and Cost effectiveness of alternative models of palliative care
CARDI – Centre for Ageing Research & Development in Ireland
TILDA
Ageing Programme
18
o Track record of evidence based service design
o Outcome and economic data in social services
o Communication of results
o Evaluation findings influenced our programmes
o The findings and lessons from our work will be one of our most tangible legacies
In conclusion
