Social Return on Investment Analysis: A Mixed Methods Approach to Assessing the Value of Adult Hospice Services

Objectives Hospice services offer invaluable support to individuals facing life-limiting illnesses; however, quantifying their positive impact presents a challenge. As the demand for palliative care rises because of complex illnesses and an aging population, hospices face the need to prove their value. With funding primarily reliant on charitable donations and limited statutory support, they must demonstrate their effectiveness to secure additional resources in a competitive landscape. Methods This study used the Social Return on Investment framework to evaluate the social value generated by four hospice sites offering inpatient and day therapy services across North Wales. Through a mixed-methods approach, quantitative and qualitative data were collected to explore stakeholder experiences, values, and outcomes, facilitating a thorough examination of the broader social impact of hospice care. Results The average input and output values for the inpatient unit were £602 100 and £1 667 861, respectively, thus returning a base case ratio of £2.77:£1. The day therapy unit had average input and output costs of £155 928 and £1 847 347, respectively, hence a base-case ratio of £11.85:£1. Sensitivity analysis yielded estimates of between £2.20:£1 and £6.83:£1 for the inpatient unit and between £2:44:£1 and £19:51:£1 for the day therapy unit. Conclusions As healthcare providers globally confront challenges with resource constraints, adopting value-driven methodologies becomes crucial. Embracing such methodologies fosters a more comprehensive understanding of value, transcending traditional metrics to encompass social, environmental, and long-term sustainability considerations