摘要：Objectives. To estimate the average return on investment for the overall activities of county departments of public health in California. Methods. I gathered the elements necessary to estimate the average return on investment for county departments of public health in California during the period 2001 to 2008–2009. These came from peer-reviewed journal articles published as part of a larger project to develop a method for determining return on investment for public health by using a health economics framework. I combined these elements by using the standard formula for computing return on investment, and performed a sensitivity analysis. Then I compared the return on investment for county departments of public health with the returns on investment generated for various aspects of medical care. Results. The estimated return on investment from $1 invested in county departments of public health in California ranges from $67.07 to $88.21. Conclusions. The very large estimated return on investment for California county departments of public health relative to the return on investment for selected aspects of medical care suggests that public health is a wise investment. Is the public health system a good investment? Information about the return on investment for public health systems is an essential input to sound health policy decision-making, but has been difficult to ascertain. Determining the return on investment for the public health system as a whole—at least from the point of view of county departments of public health—requires 4 types of information: (1) a complete set of health outcomes that can be causally attributed to the expenditures of county departments of public health, (2) the time paths of these expenditures and outcomes, (3) the level of expenditures used to produce the outcomes, and (4) monetary valuations of each outcome. With this information, one could determine the discounted present value of both public health outcomes and the level of expenditures used to produce them, the components of return on investment for the public health system. Each of these 4 types of information is now available via a series of research articles appearing in health economics journals and health services journals, which make it possible for the first time to estimate the return on investment for the public health system in California. 1–3 This series of research articles was generated as part of a larger project to develop a method for determining return on investment for public health by using a health economics framework. In this study, I draw together each of the 4 types of information necessary to estimate return on investment, briefly explain the manner in which each of the 4 types of information was determined, and then combine these to estimate return on investment.
