Cost-effectiveness analysis in the nursing literature, 1992-1996

To review the recommendations by the U.S. Panel on Cost-Effectiveness in Health and Medicine (panel) for use in future nursing research. The review (a) provides a critique of the nursing cost-effectiveness and cost utility literature from the perspective of the recommendations set forth by the panel and other recognized authorities in cost-effectiveness analysis (CEA), (b) constructs an interdisciplinary framework to show the steps in the conduct of CEA, (c) makes the techniques and major findings of nursing CEA studies available and understandable, and (d) offers guidelines for the incorporation of CEA into the evaluation of future nursing intervention and research.

Seven nursing studies published between 1992 and 1996 that compared two or more interventions for costs and outcomes.

For each study, the (a) perspective, (b) net costs, (c) net effect, (d) analysis of costs and effects, and (e) decision outcomes were analyzed.

If the panel's recommendations reflect the problems in the health care CEA literature in general, then on balance, the nursing CEA 1992-1996 studies are no more or less flawed than CEA studies in the health or medical care fields.

Methodologic guidelines and interdisciplinary strategies are needed to advance the progress of nursing cost-effectiveness research.