Cost-effectiveness decision modelling in social care:exploring the why, the how, and the what next

CONTEXT: In social care research economic evaluation has had limited impact, in contrast to other health related areas. However, increasing research funding and policy interest is occurring, including regarding the role of cost-effectiveness decision modelling. OBJECTIVES: We explore why cost-effectiveness decision modelling is informative in a social care setting, how it can and has previously been implemented, and what next steps are needed to ensure consistent, robust, and informative models are produced to inform social care decisions. METHOD: This paper consists of an overview of the theoretical added value of cost-effectiveness decision modelling in a social care setting, alongside a literature search summarising the key features of decision models in the current published and grey literature. FINDINGS: Cost-effectiveness decision modelling in social care is relatively undeveloped with only a few examples identified and minimal methodological research in the area. These studies varied greatly in the approaches taken but demonstrate the practicality and value of decision modelling. LIMITATIONS: The pragmatic approach to the literature review may have missed some existing decision models but we consider the findings to be appropriate. IMPLICATIONS: Cost-effectiveness decision modelling has the potential to play an important role in informing effective, consistent, and transparent decision-making processes in social care. However, methodological developments are needed to standardise the approaches taken.