Methodological issues in linking costs and health outcomes in research on differing care delivery systems.
OBJECTIVE
This article discusses, from an economist's point of view, issues in designing and conducting research including cost and outcomes variables among differing care delivery systems.


METHODS
Issues were identified, and selected research purporting to link cost and outcomes with variations in care delivery systems was reviewed.


RESULTS
Current literature on nursing care delivery systems and costs in hospitals, ambulatory care, and nursing homes is focused mainly on group-specific costs linked to patient-specific outcomes. It suffers further from focusing primarily on single-discipline components of care, omitting the contributions of other providers beyond nursing personnel.


CONCLUSIONS
Multidisciplinary teams, including economists who can speak clinical language, are recommended.
Hogan
A J
AJ
Department of Medicine, College of Human Medicine, Michigan State University, East Lansing 48824, USA.
D000553:Ambulatory Care / Q000191:economics / Q000458:organization & administration; D003362:Cost-Benefit Analysis; D003627:Data Interpretation, Statistical; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D008329:Managed Care Programs; D017059:Models, Econometric; D017146:Models, Organizational; D009735:Nursing Homes / Q000191:economics / Q000458:organization & administration; D017063:Outcome Assessment, Health Care / Q000379:methods*