Table 3.

Return on Investment

		2013	2014	2015	2016a	Total
Cost of ACP
Education program cost ($)b	A	$43,980	$42,932	$56,791	$18,237	$161,941
Number of ACPs done (person)	B	4672	3985	4448	1489	14,594
Weighted average cost per ACP ($)c	C					$29.54
Execution cost ($)	D = B × C					$431,107
Maintenance cost of program ($)	E	$120,054	$159,047	$155,015	$49,282	$483,398
Start-up cost ($)	F					$438,724
Total ACP intervention cost ($)	G = A+D+E+F					$1,515,170
Benefit of ACP
Reduced expenditure of last 12 months of life per patient ($)	H					$9,500
Number of patients died (person)	I					325
Total benefit of ACP intervention ($)	J = H × I					$3,087,500
ROI
Total cost ($)	K = G					$1,515,170
Net benefit (total benefit-total cost) ($)	L = J−K					$1,572,330
ROI	M = (L/K) × 100					104%

^a2016 is a partial year of January–April.

^bEducation costs increased slightly with the addition of simulation.

^cWeighted average costs reflect that the majority of ACPs were facilitated by nurses and social workers. ROI, return on investment.