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.