Nurse led versus lay educators support for those with asthma in primary care: a costing study

BMC Pulmonary Medicine

Research Article

Andrew H Briggs¹  Kathleen A Boyd¹  Nicola J Roberts²  Martyn R Partridge³  Ann L Caress⁴ 

[1] Health Economic and Health Technology Assessment, Institute of Health & Wellbeing University of Glasgow, Glasgow, UK;Institute for Applied Health Research/School of Health and Life Sciences Glasgow Caledonian University, Glasgow, UK;NHLI Division at Charing Cross Hospital, Imperial College, London, UK;Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK;

关键词: Asthma;    Telephone Consultation;    Healthcare Utilisation;    Practice Nurse;    Scenario Analysis;   

DOI  :  10.1186/1471-2466-12-52

 received in 2011-07-31, accepted in 2012-08-22,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundRegular review and support for asthma self-management is promoted in guidelines. A randomised controlled trial suggested that unscheduled health care usage was similar when patients were offered self management support by a lay-trainer or practice nurses.MethodsFollowing the RCT, a costing study was undertaken using the trial data to account for the cost of delivery of the service under both strategies and the resulting impact on unscheduled healthcare (measure of effectiveness) in this trial.ResultsOne year data (n = 418) showed that 29% (61/205) of the nurse group required unscheduled healthcare (177 events) compared with 30.5% (65/213) for lay-trainers (178 events).The training costs for the lay-trainers were greater than nurses (£36 versus £18 respectively per patient, p<0.001), however, the consultation cost for lay-trainers were lower than nurses (£6 per patient versus £24, p<0.001). If the cost of unscheduled healthcare are accounted for then the costs of nurses is £161, and £135 for lay-trainers (mean difference £25, [95% CI = −£97, £149, p = 0.681]). The total costs (delivery and unscheduled healthcare) were £202 per patient for nurses versus £178 for lay-trainers, (mean difference £24, [95%CI = −£100, £147, p = 0.707]).ConclusionsThere were no significant differences in the cost of training and healthcare delivery between nurse and lay trainers, and no significant difference in the cost of unscheduled health care use.

【 授权许可】

CC BY   
© Roberts et al.; licensee BioMed Central Ltd. 2012