Economic evaluation of specialist cancer and palliative nursing: a literature review.
Little progress has been made in economic evaluation of specialist cancer and palliative care nursing. A literature review of economic studies of clinical nurse specialists (CNSs) was undertaken to assess how the measurement of economic outcomes has been tackled in the literature to date. The initial search found 400 studies. Abstracts from all the studies were reviewed but only 17 studies met the basic criteria for inclusion, reporting primary cost and outcomes data, and clearly specifying the role of a CNS. All of the studies but one focused on direct patient care rather than other CNS roles and were undertaken alongside effectiveness studies. The economic evaluations considered only a narrow range of costs, but a wide range of outcomes. Specific nursing outcomes were only reported in a minority of studies. None of the studies reported cost-effectiveness ratios. However, CNS interventions were reported to be both less costly and more effective than alternative forms of care, negating the need for further cost-effectiveness analysis. Overall, the papers were not of good quality, reducing the validity of the findings. Robust economic evaluations of the CNS role need to be undertaken. These should involve nursing researchers and practitioners so that evaluations reflect the complex and multidimensional nature of CNS care and meet the required standard of evidence to influence practice.
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
D003362:Cost-Benefit Analysis; D006801:Humans; D009720:Nurse Clinicians / Q000191:economics*; D024802:Nurse's Role; D015403:Nursing Evaluation Research / Q000592:standards; D009859:Oncology Nursing / Q000191:economics*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000191:economics*; D012107:Research Design / Q000592:standards