Paper
Thursday, July 22, 2004
Economic Analyses in Nursing Intervention Research
Jerilyn K. Allen, RN, ScD, FAAN, School of Nursing, School of Nursing, Johns Hopkins University, Baltimore, MD, USA
Problem: In the current arena of cost-conscious healthcare, it is imperative that research evaluating the effectiveness of nursing interventions include an economic analysis. However, there is minimal information on the cost-effectiveness of nursing interventions reported in the literature. Purpose: The purpose of this presentation is to describe the common types of economic studies: cost identification, cost-benefit, and cost-effective analyses along with the strengths and limitations of each approach. Approach: In a cost-identification study, only the costs of a given intervention are calculated. Cost-benefit analysis adds another dimension by also assessing the benefits accrued measured in the same terms, usually dollars. Cost effectiveness analysis also compares costs with benefits; however costs and benefits are expressed in different units. Costs are expressed in terms of dollars and benefits in terms of units of health outcome gained, such as cost per mg of cholesterol reduction in the population, or cost per quality adjusted life year gained. The challenges associated with the application of these methodologies within the context of a “real world” trial of a nursing intervention are numerous. Some approaches to deal with these challenges using relevant examples will be proposed. Results from a cost-effectiveness evaluation of a nurse-managed program for cholesterol reduction will be presented. Implications: Comprehensive evaluation of the effectiveness of nursing interventions is enhanced by the inclusion of economic analyses in the study design.
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Sigma Theta Tau International
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