The cost and cost-effectiveness of nursing services in health care.
This article examines the literature on cost-effectiveness in nursing, and considers the relationship between this literature and decision-making in health care systems. Researchers have attempted to examine costs and benefits of nurse staffing and nursing interventions for decades. There are strong literatures for some topics, such as advanced practice nursing, clinical practices, occupational health nursing, and workplace training. However, there are gaps in the literature on the cost-effectiveness of nurse staffing patterns, the use of agency personnel, and changes in organizational structure. A review of 6 major health care management textbooks finds few references to cost-effectiveness analysis, suggesting that health care leaders have little education regarding how to conduct or evaluate economic studies. The agenda for nursing research on cost-effectiveness is daunting. Research must be based on large, representative samples; provide clear, compelling results; discuss the importance of both costs and benefits in decision-making; and be published in highly-visible journals.
Spetz
Joanne
J
University of California-San Francisco, 3333 California Street, Suite 410, San Francisco, CA 94118, USA. jojo@alum.mit.edu
D003362:Cost-Benefit Analysis; D003659:Decision Making, Organizational; D005544:Forecasting; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D009718:Nurse Administrators / Q000193:education / Q000458:organization & administration; D015401:Nursing Administration Research / Q000193:education / Q000458:organization & administration*; D009739:Nursing Services / Q000191:economics* / Q000592:standards; D009740:Nursing Staff / Q000458:organization & administration; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011643:Publishing; D011787:Quality of Health Care / Q000191:economics / Q000592:standards; D012107:Research Design