References on Cost Effectiveness and Quality of Care Provided by APNs and Sample Calculation of Your Cost Effectiveness

Cost-effectiveness may be defined as a method used to compare two or more interventions and chose an alternative that is best (BetterEvaluation, 2014). According to Bauer (2010), “cost-effective outcome is the least-expensive way to produce a specified good or service.” Nurse practitioners primarily deal with patient care. They are able to see patients from hospital to home settings. The knowledge on cost effectiveness is important to nurse practitioners because it allows them to be able to provide the best and most cost effective care to the patients. Multiple studies (see the list of references below) have been done to compare the cost effectiveness of services provided by nurse practitioners and to those provided by primary care physicians. Nurse practitioners have shown to be more cost effective compared to primary care physicians.  The AANP (2013) reports that “Nurse managed centers (NMCs) with NP-provided care have demonstrated significant savings, less costly interventions, and fewer emergency visits and hospitalizations.” Fund, M. E., & Swanson-Hill, A. (2014) and Iowa nurse reporter (2012) reports that nurse practitioners has seen to have the best quality and cost effective primary care delivery.

Sample cost-effectiveness calculation:

Method provided by Harvard University (2016): The average cost effectiveness = Net Cost/ Net Health Benefit = $/QALY (gained) or $/DALY (eliminated)

A good example will be comparing cost for IV fluid administrations to drinking water and/or oral fluids at home to solve a problem of dehydration. If the cost for IV fluids administration is $1000 which is more expensive than oral fluids and the health benefit (rehydration) which is about 50 times. The average cost effectiveness will be $20

The average cost effectiveness of intervention A = Net Cost/ Net Health Benefit = $1000/50 QALYs = $20/QALY

 References

American Association of Nurse Practitioners. (2013). Nurse Practitioner Cost-Effectiveness. Retrieved from https://www.aanp.org/images/documents/publications/costeffectiveness.pdf

Bauer, J. C. (2010). Nurse practitioners as an underutilized resource for health reform: evidence-based demonstrations of cost-effectiveness. Journal of the American Academy of Nurse Practitioners, 22(4), 228-231. DOI:10.1111/j.1745-7599.2010.00498.x. (1)

BetterEvauation. (2014). Cost Effectiveness Analysis. Retrieved from http://betterevaluation.org/en/evaluation-options/CostEffectivenessAnalysis

Fund, M. E., & Swanson-Hill, A. (2014). Cost-Effectiveness of Nurse Practitioner Care. Kansas Nurse, 89(1), 12-15.

Harvard University. (2016). How to do cost-effectiveness calculations in a nutshell. Retrieved from http://isites.harvard.edu/fs/docs/icb.topic65021.files/Cost_Effectiveness_basic_instructions_for_students.doc.

Kilpatrick, K., Kaasalainen, S., Donald, F., Reid, K., Carter, N., Bryant-Lukosius, D., & ... DiCenso, A. (2014). The effectiveness and cost-effectiveness of clinical nurse specialists in outpatient roles: a systematic review. Journal Of Evaluation In Clinical Practice, 20(6), 1106-1123. doi:10.1111/jep.12219

Shafrin, J. (2006). The cost effectiveness of Nurse Practitioners. Retrieved from http://healthcare-economist.com/2006/07/19/the-cost-effectiveness-of-nurse-practitioners/

The Cost Effectiveness of Nurse Practitioner Care. (2012). Iowa Nurse Reporter, 25(3), 10-12.

Vanhook, P. (2007). Cost-Utility Analysis: A Method of Quantifying the Value of Registered Nurses. OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3, DOI: 10.3912/OJIN.Vol12No03Man05