Hi, my name is Phaeda Corso.
I'm the UGA Foundation Professor in Human Health at the College of Public Health at
the University of Georgia.
And today, I'm going to be talking about the cost of violence.
Before I get into the full understanding of what are costs, I want to,
at least put this into the context of the public health model for prevention.
How do we think about economic analysis in the context of public health?
So if you think about a model of prevention,
we typically start off with identifying the problem, from there we do research,
ideologic research on the risk and
protective factors of violence, then we go in to program development.
From program development, we go into program evaluation, and
this includes both efficacy and effectiveness research.
And then once we have evidence of efficacy and
effectiveness, then we go into wide spread implementation and dissemination.
So this is a theoretic model, and it's a feedback loop, and
this is really how we like to set up, our public health model.
So where does economic analysis play a role?
Specifically where does cost of illness analysis play a role?
So, if you look here under problem identification.
Problem identification is thinking about what is the morbidity associated with
violence, what is the mortality associated with violence, and in the same way,
we can think about what are the costs of violence, so
this is a very critical part of the public health model.
So, what is economic impact or cost of illness analysis?
This is a methodology that assesses the total cost of a disease or
condition or an illness or an injury.
And we're typically considering in this costing, the medical cost associated with
the injury, and the non-medical cost associated with the injury.
And then we also include productivity losses due to the injury.
And we'll go through each one of these in turn.
So first, let's talk about the medical and non-medical costs.
The medical costs of an injury or an illness are,
you can think about all those things for which a claim is a claim is based.
So you can think about inpatient admissions.
Emergency room visits, going to your physician's office
getting prescription drugs, all of those fall under the category of medical costs.
What are examples of non-medical costs?
Those are other costs associated with the injury like those that occur in the legal
system for investigating a crime travel ex, expenses to seek out treatment.
Sometimes we include childcare for, for when a,
an adult is seeking treatment, as well.
So, let me just give you an example.
So, this this is an example of costing out illness averted due to a vaccine.
So, if we think about the direct medical costs associated with a vaccine,
we think about medical costs averted and
we can think about outpatient visits and fewer hospitalizations.
So what pieces of information would you need to
know to cost out an outpatient visit for example?
What pieces of information do you need to know to cost out a hospitalization?
So in this example, let's say we're talking about averting a case of
Influenza due to vaccine to cost out the outpatient visits,
we would need to know the what is the Influenza rate.
We'd need to know the number of health care provider visits per
Influenza episode.
We'd need to know some information on how effective the vaccine is, and
we then would then also need to pair that information with the cost of the visit to
a healthcare provider.
Likewise, with the cost for hospitalization, we would need to
know what is the hospitalization rate associated with Influenza.
How effective is the vaccine again, and what is the caught, the cause for
acute respiratory conditions the hospitalization costs.
So now let's move to productivity losses.
So this is medical costs, non-medical costs, and
now we care about productivity losses.
So how do we define productivity losses?
In the US, we use what's called the Human Capital Approach.
And this was really developed in the ear, the late 50s, the early 60s.
Dorothy Rice is, is the, is the famous professor who's brought this
methodology to the US and it's basically applying a human capital theory to health.
So we quantified the economic benefits of a person based on their education,
which translates into their income.
So this is how we come up with the cost of illness on the productivity loss side.
In, outside of the US we have other ways of measuring
productivity loses including the Friction cost method and
Revealed preference, and I'll go into those a little bit.
In one moment.
But let's first focus on the Human Capital Approach.
Since this is what we're using here in the US.
So the Human Capital Approach is based on the Theory of investment and
that is that the human being is, is valued based on your capital investment.
So you can think about your value in society based on how productive you are.
And how do we measure your productivity to society?
It's based on your earnings.
Not just your earnings in the workplace, but
also your productivity within the household as well.
So what we do in this approach, is we place a monetary value on
your healthy time or if you think about averting an illness, we place a value on
that time lost from work, for example, or time lost from leisure time.
