The Cost-Effectiveness and Cost-Consequences of a School-Based Social Worker Intervention: A Within-Trial Economic Evaluation

21 Pages Posted: 28 Mar 2024

See all articles by Elizabeth-Ann Schroeder

Elizabeth-Ann Schroeder

University of Oxford

David Westlake

affiliation not provided to SSRN

Shahd Daher

University of Oxford

Linda Adara

affiliation not provided to SSRN

Sharon Ayayo

The University of Manchester

Verity Bennett

affiliation not provided to SSRN

sungwook Kim

University of Oxford

Fiona Lugg-Widger

affiliation not provided to SSRN

Melissa Meindl

affiliation not provided to SSRN

Lena Meister

affiliation not provided to SSRN

Kim Munnery

affiliation not provided to SSRN

Philip Pallmann

affiliation not provided to SSRN

Louise Roberts

affiliation not provided to SSRN

Sarah Rawlinson

affiliation not provided to SSRN

James White

Cardiff University - Centre for Trials Research

Stavros Petrou

University of Oxford - Nuffield Department of Primary Care Health Sciences

Abstract

Schools are a significant source of referrals to Children’s Social Care (CSC) services. A within-trial economic evaluation estimated the cost-effectiveness of embedding social workers in schools in England (SWIS) compared to usual practice.  Two hundred and sixty-eight schools comprising 277,888 students were randomised. The primary outcome of the trial was section 47 enquiries (i.e. child protection referrals to CSC services). The economic evaluation estimated the incremental cost-effectiveness of SWIS in reducing section 47 enquiries. Micro-costing approaches assessed the cost of the social worker intervention and addressed variability in key unit costs. Mean differences in costs and outcomes were estimated, with bootstrap 95% confidence intervals and scaling to incidence rate ratios per 1000 students per year. No statistically significant differences between trial arms were identified for any outcomes, costs or cost-effectiveness over a 23-month follow-up. The probability that SWIS is cost-effective was estimated for a range of willingness to pay values. At threshold values of £1000, £10,000 and £20,000 were probabilities for cost-effectiveness were estimated as 1.3%, 1.1% and 6.1%. This means SWIS had a low probability of being cost-effective.

Keywords: Economic evaluation Cost-effectivenessChildren's social care

Suggested Citation

Schroeder, Elizabeth-Ann and Westlake, David and Daher, Shahd and Adara, Linda and Ayayo, Sharon and Bennett, Verity and Kim, sungwook and Lugg-Widger, Fiona and Meindl, Melissa and Meister, Lena and Munnery, Kim and Pallmann, Philip and Roberts, Louise and Rawlinson, Sarah and White, James and Petrou, Stavros, The Cost-Effectiveness and Cost-Consequences of a School-Based Social Worker Intervention: A Within-Trial Economic Evaluation. Available at SSRN: https://ssrn.com/abstract=4776734 or http://dx.doi.org/10.2139/ssrn.4776734

Elizabeth-Ann Schroeder (Contact Author)

University of Oxford ( email )

Mansfield Road
Oxford, OX1 4AU
United Kingdom

David Westlake

affiliation not provided to SSRN ( email )

No Address Available

Shahd Daher

University of Oxford ( email )

Mansfield Road
Oxford, OX1 4AU
United Kingdom

Linda Adara

affiliation not provided to SSRN ( email )

No Address Available

Sharon Ayayo

The University of Manchester

Verity Bennett

affiliation not provided to SSRN ( email )

No Address Available

Sungwook Kim

University of Oxford

Fiona Lugg-Widger

affiliation not provided to SSRN ( email )

No Address Available

Melissa Meindl

affiliation not provided to SSRN ( email )

No Address Available

Lena Meister

affiliation not provided to SSRN ( email )

No Address Available

Kim Munnery

affiliation not provided to SSRN ( email )

No Address Available

Philip Pallmann

affiliation not provided to SSRN

Louise Roberts

affiliation not provided to SSRN ( email )

No Address Available

Sarah Rawlinson

affiliation not provided to SSRN ( email )

No Address Available

James White

Cardiff University - Centre for Trials Research ( email )

Cardiff
United Kingdom

Stavros Petrou

University of Oxford - Nuffield Department of Primary Care Health Sciences ( email )

Oxford
United Kingdom

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