This article presents the findings from a critical review of cost-effectiveness research in children's social care. With a focus on the past 20 years (since 2000), the review aims to assess the use and consistency of definitions relevant to evaluating cost-effectiveness such as financial input (costs) and outcomes, and to review and summarise learnings from cost-effectiveness studies in the English children's social care system. We included both academic and grey literature and identified 61 relevant publications for inclusion. The results are organised according to three themes: costs, outcomes and cost-effectiveness. We identified that a large proportion of studies contained a discussion on cost, spend or unit cost, and an equal proportion of articles concerned outcomes of service, benefit to children or quality of service provided. The number of studies discussing cost-effectiveness, cost–benefit or economic evaluation was considerably smaller. The findings highlight substantial gaps in the literature, with a disproportionate focus on stating the problem in terms of cost pressures, and very little robust evidence about cost-effectiveness. Furthermore, the article sets out methodological limitations and indicates a lack of transparency in many of the report studies. We conclude that as a result of the gaps and limitations it is difficult for policymakers and other stakeholders in children's services to make evidence-informed decisions about the best use of their limited resources.

中文翻译：

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对儿童社会关怀成本效益研究的批判性回顾：到目前为止，我们学到了什么？

本文介绍了对儿童社会护理成本效益研究的批判性审查的结果。该审查侧重于过去 20 年（自 2000 年以来），旨在评估与评估成本效益相关的定义的使用和一致性，例如财务投入（成本）和成果，并审查和总结成本效益的经验教训在英国儿童的社会关怀系统研究。我们纳入了学术和灰色文献，并确定了 61 篇相关出版物供纳入。结果根据三个主题进行组织：成本、结果和成本效益。我们发现，大部分研究都讨论了成本、支出或单位成本，同样比例的文章涉及服务结果、对儿童的益处或所提供的服务质量。讨论成本效益、成本效益或经济评估的研究数量要少得多。研究结果突出了文献中的巨大差距，不成比例地侧重于从成本压力的角度来说明问题，而关于成本效益的有力证据却很少。此外，文章列出了方法上的局限性，并指出许多报告研究缺乏透明度。我们得出的结论是，由于存在差距和局限性，决策者和儿童服务的其他利益相关者很难就如何最好地利用其有限的资源做出有依据的决策。过分关注成本压力方面的问题，而关于成本效益的有力证据很少。此外，文章列出了方法上的局限性，并指出许多报告研究缺乏透明度。我们得出的结论是，由于存在差距和局限性，决策者和儿童服务的其他利益相关者很难就如何最好地利用其有限的资源做出有依据的决策。过分关注成本压力方面的问题，而关于成本效益的有力证据很少。此外，文章列出了方法上的局限性，并指出许多报告研究缺乏透明度。我们得出的结论是，由于存在差距和局限性，决策者和儿童服务的其他利益相关者很难就如何最好地利用其有限的资源做出有依据的决策。