Home visiting programmes for the prevention of child maltreatment: Cost-effectiveness of 33 programmes

Kim Dalziel, Leonie Segal

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


Objective: There is a body of published research on the effectiveness of home visiting for the prevention of child maltreatment, but little in the peer reviewed literature on cost-effectiveness or value to society. The authors sought to determine the cost-effectiveness of alternative home visiting programmes to inform policy. Study design: All trials reporting child maltreatment outcomes were identified through systematic review. Information on programme effectiveness and components were taken from identified studies, to which 2010 Australian unit costs were applied. Lifetime cost offsets associated with maltreatment were derived from a recent Australian study. Cost-effectiveness results were estimated as programme cost per case of maltreatment prevented and net benefit estimated by incorporating downstream cost savings. Sensitivity analyses were conducted. Results: 33 home visiting programmes were evaluated and cost-effectiveness estimates derived for the 25 programmes not dominated. The incremental cost of home visiting compared to usual care ranged from A$1800 to A$30 000 (US$1800- US$30 000) per family. Cost-effectiveness estimates ranged from A$22 000 per case of maltreatment prevented to several million. Seven of the 22 programmes (32%) of at least adequate quality were cost saving when including lifetime cost offsets. Conclusions: There is great variation in the costeffectiveness of home visiting programmes for the prevention of maltreatment. The most cost-effective programmes use professional home visitors in a multidisciplinary team, target high risk populations and include more than just home visiting. Home visiting programmes must be carefully selected and well targeted if net social benefits are to be realised.

Original languageEnglish
Pages (from-to)787-798
Number of pages12
JournalArchives of Disease in Childhood
Issue number9
Publication statusPublished or Issued - Sept 2012
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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