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Cost Effectiveness Analysis for Nursing Research

Bensink, Mark E.; Eaton, Linda H.; Morrison, Megan L.; Cook, Wendy A.; Curtis, R. Randall; Gordon, Deborah B.; Kundu, Anjana; Doorenbos, Ardith Z.

doi: 10.1097/NNR.0b013e318298b0be

Background: With ever-increasing pressure to reduce costs and increase quality, nurses are faced with the challenge of producing evidence that their interventions and care provide value. Cost effectiveness analysis (CEA) is a tool that can be used to provide this evidence by comparative evaluation of the costs and consequences of two or more alternatives.

Objectives: The aim of this article is to introduce the essential components of CEA to nurses and nurse researchers with the protocol of a recently funded cluster randomized controlled trial as an example.

Methods: This article provides (a) a description of the main concepts and key steps in CEA and (b) a summary of the background and objectives of a CEA designed to evaluate a nursing-led pain and symptom management intervention in rural communities compared with the current usual care.

Discussion: As the example highlights, incorporating CEA into nursing research studies is feasible. The burden of the additional data collection required is offset by quantitative evidence of the given intervention’s cost and impact using humanistic and economic outcomes. At a time when U.S. healthcare is moving toward accountable care, the information provided by CEA will be an important additional component of the evidence produced by nursing research.

Mark E. Bensink, PhD, MSc, Med, is Research Scientist, Research and Economic Assessment in Cancer and Health Care (REACH) Group, Fred Hutchinson Cancer Research Center, University of Washington.

Linda H. Eaton, Doctoral candidate, MN, RN, AOCN, is Research Nurse, School of Nursing, University of Washington.

Megan L. Morrison, Doctoral candidate, MSN, RN, ARNP, FNP-BC, is Nurse Practitioner, School of Nursing, Northwest Hospital and Medical Center, University of Washington.

Wendy A. Cook, Doctoral candidate, MSN, RN, is Doctoral Student, School of Nursing, University of Washington.

R. Randall Curtis, MD, MPH, is Professor; and Anjana Kundu, MBBS, DA, is Associate Professor, School of Medicine, University of Washington.

Deborah B. Gordon, DNP, is Clinical Assistant Professor; and Ardith Z. Doorenbos, PhD,RN, FAAN, is Associate Professor, School of Nursing and School of Medicine,University of Washington.

Accepted for publication April 10, 2013.

Research reported in this publication was supported by the National Institute of Nursing Research of the National Institutes of Health under award number R01NR012450 and the University of Washington Palliative Care Center of Excellence. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors have no conflicts of interest to disclose.

Corresponding author: Ardith Z. Doorenbos, PhD, RN, FAAN, Biobehavioral Nursing & Health Systems, School of Nursing, University of Washington, Box 357266, 4311 11th Ave. NE, Seattle, WA 98195 (e-mail:

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.