Abstract：
AIMS:To examine the cost-effectiveness of a nurse practitioner-family physician model of care compared with family physician-only care in a Canadian nursing home. BACKGROUND:As demand for long-term care increases, alternative care models including nurse practitioners are being explored. DESIGN:Cost-effectiveness analysis using a controlled before-after design. METHODS:The study included an 18-month 'before' period (2005-2006) and a 21-month 'after' time period (2007-2009). Data were abstracted from charts from 2008-2010. We calculated incremental cost-effectiveness ratios comparing the intervention (nurse practitioner-family physician model; n = 45) to internal (n = 65), external (n = 70) and combined internal/external family physician-only control groups, measured as the change in healthcare costs divided by the change in emergency department transfers/person-month. We assessed joint uncertainty around costs and effects using non-parametric bootstrapping and cost-effectiveness acceptability curves. RESULTS:Point estimates of the incremental cost-effectiveness ratio demonstrated the nurse practitioner-family physician model dominated the internal and combined control groups (i.e. was associated with smaller increases in costs and emergency department transfers/person-month). Compared with the external control, the intervention resulted in a smaller increase in costs and larger increase in emergency department transfers. Using a willingness-to-pay threshold of $1000 CAD/emergency department transfer, the probability the intervention was cost-effective compared with the internal, external and combined control groups was 26%, 21% and 25%. CONCLUSION:Due to uncertainty around the distribution of costs and effects, we were unable to make a definitive conclusion regarding the cost-effectiveness of the nurse practitioner-family physician model; however, these results suggest benefits that could be confirmed in a larger study.
journal_name
J Adv Nursjournal_title
Journal of advanced nursingauthors
Lacny S,Zarrabi M,Martin-Misener R,Donald F,Sketris I,Murphy AL,DiCenso A,Marshall DAdoi
10.1111/jan.12989subject
Has Abstractpub_date
2016-09-01 00:00:00pages
2138-52issue
9eissn
0309-2402issn
1365-2648journal_volume
72pub_type
杂志文章abstract：AIM:To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery. BACKGROUND:Previous research has indicated that average self-rated pain reflects patients' ability to recover the same day. However, there is a kn...
journal_title：Journal of advanced nursing
pub_type： 杂志文章
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abstract：AIM:This paper is a report of a study of the views of prisoners about health services provided in prisons. BACKGROUND:Prison provides an opportunity for a 'hard to reach' group to access health services, primarily those provided by nurses. Prisoners typically have high health and social needs, but the views and experi...
journal_title：Journal of advanced nursing
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doi：10.1111/j.1365-2648.2007.04221.x
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journal_title：Journal of advanced nursing
pub_type： 杂志文章,多中心研究
doi：10.1111/j.1365-2648.1996.tb02668.x
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abstract：:By examining the relationship between the cultural construction of female sexuality and the lack of potential for many young heterosexual women to be truly sexually healthy this paper submits that messages for women within HIV prevention programmes can be confused, confining and at times dangerous to women's health an...
journal_title：Journal of advanced nursing
pub_type： 杂志文章,评审
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journal_title：Journal of advanced nursing
pub_type： 杂志文章,多中心研究
doi：10.1046/j.1365-2648.2002.02429.x
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journal_title：Journal of advanced nursing
pub_type： 杂志文章
doi：10.1111/j.1365-2648.1986.tb03389.x
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journal_title：Journal of advanced nursing
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doi：10.1046/j.1365-2648.2001.02008.x
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journal_title：Journal of advanced nursing
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doi：10.1111/jan.12074
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journal_title：Journal of advanced nursing
pub_type： 杂志文章,评审
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
pub_type： 杂志文章
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journal_title：Journal of advanced nursing
pub_type： 杂志文章
doi：10.1111/jan.13303
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journal_title：Journal of advanced nursing
pub_type： 杂志文章
doi：10.1046/j.1365-2648.1996.02047.x
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journal_title：Journal of advanced nursing
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doi：10.1111/jan.12669
更新日期：2015-09-01 00:00:00
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journal_title：Journal of advanced nursing
pub_type： 杂志文章,评审
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
pub_type： 杂志文章
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
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journal_title：Journal of advanced nursing
pub_type： 杂志文章
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更新日期：1988-01-01 00:00:00
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journal_title：Journal of advanced nursing
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