Implementation Cost Analysis of an Intensive Comprehensive Aphasia Program

Objective: To identify and measure the costs of implementing an intensive comprehensive aphasia program (ICAP). Design: Retrospective cost analysis of a clinical ICAP. Cost inputs were gathered directly from the provider of the ICAP. We performed several sensitivity analyses to examine major cost drivers and to separate start-up costs from operating costs. Setting: Urban rehabilitation hospital. Participants: Adults with aphasia. Main Outcome Measures: Total implementation cost to the provider. Results: Implementation cost of running the ICAP for the first time was $133,644 for a cohort of 8 participants with aphasia. Break-even charges per participant ranged from $15,278 for 10 participants to $19,700 for 6 participants. After accounting for start-up costs and efficiencies gained, the fourth and subsequent programs were estimated to cost $84,855 each. The majority of the costs were personnel costs, and the cost of the speech language pathologist's time was the main cost driver in this analysis. Conclusions: Initial implementation costs are high compared with subsequent programs. Future work should examine effectiveness of an ICAP compared with other treatments to determine its cost-effectiveness. (c) 2020 by the American Congress of Rehabilitation Medicine

Automated summary

The objective of this study was to identify and measure the costs of implementing an intensive comprehensive aphasia program (ICAP). The results showed that the initial implementation costs for the ICAP were high, but the subsequent programs were estimated to have lower costs. Personnel costs, specifically the cost of the speech language pathologist's time, were identified as the main cost driver.