Attitudes and opinions of dietetics professionals toward cost-benefit and cost-effectiveness analyses

Objective To compare the attitudes and opinions of dietitians and dietary managers in regard to cost-benefit analysis (CBA) and cost-effectiveness analysis (CEA). Design A questionnaire was sent nationwide to a sample of 1,074 dietitians and 545 dietary managers. Subjects/samples The dietitians were randomly selected from the dietitians practice groups of The American Dietetic Association that have practitioners with administrative responsibilities in health care: Clinical Nutrition Management, Consultant Dietitians in Health Care Facilities, and Management in Healthcare Systems. The random sample of dietary managers was drawn from the membership list of the Dietary Managers Association. Main outcome measures We hypothesized that there would be a difference between the dietitians managers in their attitudes about, and experiences in conducting CBA and CEA. Statistical analyses Data analysis incorporated frequencies, means, and standard deviations to describe the respondents. Pearson's pairwise correlations and analysis of variance examined the significance of the relationships among the variables of the study. Scheffe's test was conducted to identify which variables related closely to each other. Results Seven hundred twenty-two usable questionnaires were returned, which gave an overall response rate of 47%. Although both professional groups had experience with reducing costs at their jobs, they did not think it important to conduct CBA and CEA. Neither group could distinguish between CBA and CEA. Dietitians, who were more positive toward using CBA and CEA, saw them as important techniques that could justify the value of dietetics services. Dietitians were also more likely than the dietary managers to use the techniques in the future. Dietitians were beginning to explore the techniques, but they did not feel that good sources of information were available for conducting CBA and CEA studies. Applications/conclusions Our findings suggest a strong need to educate dietitians and dietary managers in the technique and proper use of CBA and CEA in practice settings. Dietitians need to be guided to appropriate teaching materials and educational programs, and dietary managers first have to be educated about the importance and the benefits of using the techniques. J Am Diet Assoc. 1994; 94: 386-389.