Economic evaluation of specialist cancer and palliative nursing: Macmillan evaluation study findings.
Economic evaluation of specialist nursing interventions is challenging because of the complex nature of interventions and the difficulty of describing nursing outcomes in simple ways. This article discusses data from a study of Macmillan specialist cancer nursing. Resource-use data and nursing-outcome data were collated from 76 case studies of patients referred to 12 specialist cancer and palliative nursing teams (home-based and hospital-based) in the UK. Specific outcomes related to nursing were defined, and cost and nursing outcome data were analysed together. The data suggested that patients who reported better nursing outcomes had a higher proportion of specialist nursing interventions than those reporting poor nursing outcomes (45% versus 25%). Also, the overall pattern of health-care use was different for those patients who reported positive nursing outcomes. This suggests that positive nursing outcomes can influence patients' access to other health services. The data supported specific hypotheses regarding ways that specialist nurses can influence the cost-effectiveness of care. These data do not constitute a comparative evaluation study, as no control group was identified. Such results are nevertheless important as this type of data has not been gathered previously.
Health Services Research Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. hannah-rose.douglas@lshtm.ac.uk
Hannah-Rose
HR
Douglas
Debbie
D
Halliday
Charles
C
Normand
Jessica
J
Corner
Peter
P
Bath
Nicola
N
Beech
David
D
Clark
Philippa
P
Hughes
Rachael
R
Marples
Jane
J
Seymour
Julie
J
Skilbeck
Tom
T
Webb
D003363:Cost Control; D003362:Cost-Benefit Analysis; D006801:Humans; D009720:Nurse Clinicians / Q000191:economics*; D024802:Nurse's Role; D015403:Nursing Evaluation Research / Q000458:organization & administration; D009859:Oncology Nursing / Q000191:economics*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D010166:Palliative Care / Q000191:economics*; D012017:Referral and Consultation; D012107:Research Design / Q000592:standards; D006113:United Kingdom