What Is ROI, By The Way?

  • Subhash Pokhrel
  • Lesley Owen
  • Kathryn Coyle
  • Doug Coyle


Health outcomes derived from public health programmes must outweigh the costs of implementation and adoption. This chapter discusses how return on investment (ROI) analyses can help those spending the budget both to determine how it can be best allocated in order to maximise health benefit and to justify increased budget allocation from a centralised budget. Before an ROI analysis is commenced, one has to define the “decision problem” considering the needs of the audience or end users of the ROI analysis/tool. A major difference between the development of ROI tools and standard economic evaluation models is that the ROI tools are commissioned directly to facilitate immediate decisions through demonstrating a business case for the introduction of potential programmes or policies.


Cost-benefit Budget Public health Return on investment ROI 


  1. 1.
    Charleston AE, Banerjee A, Carande-Kulis VG. Measuring success: the case for calculating the return on investment of environmental public health tracking. J Public Health Manag Pract. 2008;14(6):600–4.CrossRefGoogle Scholar
  2. 2.
    Tappenden P. Conceptual modelling for health economic model development. HEDS Discussion Paper 12/05. 2012.Google Scholar
  3. 3.
    Miller TR, Dickerson JB, Smith ML, Ory MG. Assessing costs and potential returns of evidence-based programs for seniors. Eval Health Prof. 2011;34(2):201–25.CrossRefGoogle Scholar
  4. 4.
    Glasgow RE, Emmons KM. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 2007;28:413–33.CrossRefGoogle Scholar
  5. 5.
    Roberts M, Russell LB, Paltiel AD, Chambers M, McEwan P, Krahn M. Conceptualizing a model: a report of the ISPOR-SMDM modeling good research practices task force–2. Med Decis Making. 2012;32(5):678–89.CrossRefGoogle Scholar
  6. 6.
    Brousselle A, Benmarhnia T, Benhadj L. What are the benefits and risks of using return on investment to defend public health programs? Prev Med Rep. 2016;3:135–8.CrossRefGoogle Scholar
  7. 7.
    Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press; 2015.Google Scholar
  8. 8.
    Hargrave GE, Hiatt D. The EAP treatment of depressed employees: implications for return on investment. Emp Assist Quart. 2005;19(4):39–49.Google Scholar
  9. 9.
    Goetzel RZ, Ozminkowski RJ, Villagra VG, Duffy J. Return on investment in disease management: a review. Health Care Financ Rev. 2005;26(4):1.Google Scholar
  10. 10.
    National Institute for Health and Care Excellence (NICE). Return on investment tools. 2016.
  11. 11.
    Finkelstein EA, Trogdon JG. Public health interventions for addressing childhood overweight: analysis of the business case. Am J Public Health. 2008;98(3):411–5.CrossRefGoogle Scholar
  12. 12.
    Javitz HS, Swan GE, Zbikowski SM, Curry SJ, McAfee TA, Decker D, et al. Return on investment of different combinations of bupropion SR dose and behavioral treatment for smoking cessation in a health care setting: an employer’s perspective. Value Health. 2004;7(5):535–43.CrossRefGoogle Scholar
  13. 13.
    Leatherman S, Berwick D, Iles D, Lewin LS, Davidoff F, Nolan T, et al. The business case for quality: case studies and an analysis. Health Aff. 2003;22(2):17–30.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  • Subhash Pokhrel
    • 1
  • Lesley Owen
    • 2
  • Kathryn Coyle
    • 3
  • Doug Coyle
    • 4
  1. 1.Health Economics Research Group (HERG), Division of Health SciencesBrunel University LondonUxbridgeUK
  2. 2.Centre for GuidelinesNational Institute for Health and Care ExcellenceLondonUK
  3. 3.Health Economics Research Group (HERG)Brunel University LondonUxbridgeUK
  4. 4.School of Epidemiology and Public HealthUniversity of OttawaOttawaCanada

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