NR552 Week 7 Discussion, Cost-Effective Analysis

Cost-Effectiveness Analysis NAME Chamberlain College of Nursing NR552: Economics of Healthcare Policy Dr. Poirier DATE Access the Chamberlain on-line library (Medline/CINAHL) to locate an article analyzing a treatment option or other policy change utilizing cost-benefit or cost-effectiveness analysis. The following search terms may assist in locating an article: cost-effectiveness analysis, cost versus benefit, or cost-benefit analysis. Briefly present the topic discussed in the article. How was the cost measured? How was benefit measured? What are the implications for policy change based on the cost analysis? Cost-Effectiveness Analysis Cost-effectiveness analysis is an economic analysis that compares the costs and outcomes of different alternative interventions. Cost-effectiveness analysis is different from the cost-benefit analysis that assigns a given monetary value to a certain measure of effect. Cost-effectiveness analysis is appropriate in the healthcare sector where it is inappropriate to measure the monetary value of a given health effect. It provides an analysis method that prioritizes the allocation of resources for health interventions through identifying various projects yielding greatest health improvement. The cost-effectiveness analysis is expressed in ratio terms where the denominator is the cost associated with a certain health gain while the denominator represents a gain in health such as years of life or reduced premature births. Cost-Effectiveness Analysis of Imaging Techniques It is important to determine the cost-effectiveness of imaging techniques used in screening colorectal cancer. Cost-effectiveness analysis helps in determining the gains of using imaging to determine colorectal costs compared to the cost associated with the gains. Colorectal cancer is curable when detected early. Every year, approximately 130,000 new cases of colorectal cases are reported and 56,000 colorectal cancer-related deaths are reported (Nasseri & Langenfeld, 2017). It has been proven that imaging is an effective tool in determining the state of colorectal cancer that is important in treatment. Imaging helps the healthcare personnel determine the most appropriate therapy for the patent. Greuter, Berkhof & Fijneman (2016) conducted a cost-effectiveness analysis to determine the potential of various imaging techniques in screening colorectal cancer. The study compared several CT colonography (CTC) and MR Colonography (MRC) 5-10 yearly screening with no screening. The study also compared a 10-year colonoscopy screening and a biennial fecal immunochemical test (FIT) screening. During the study, the participation rates were trial based and the rates were varied in sensitivity analysis. The incremental lifetime costs and benefits were then determined by analyzing the patients. The study found that imaging could increase the life of individuals that go through screening by 0.030 to 0.048 years compared to those that do not go for screening (Greuter et al., 2016). The costs of the screening are calculated by evaluating various costs associated with imaging such as wages and cost of equipment. Based on the cost analysis conducted by Greuter et al. (2016), policy changes would result in significant effects. The study discovered that using imaging as a screening tool for colorectal cancer is cost effective and helps in the detection of the disease and recovery when detection is made early. Policy changes allowing imaging to be used as a screening tool in healthcare organizations would increase the life of many people. Through imaging, people with colorectal cancer would have their conditions detected and treated early thus saving many lives. Besides, the healthcare costs associated with treating individuals with colorectal cancer would be reduced significantly. It is apparent that creating a policy based on the findings that imaging is effective in screening colorectal cancer would improve healthcare in a substantial way. Cost-effectiveness analysis is an important technique in determining the allocation of resources for various health intervention. In the case of the study conducted by Greuter et al. (2016) conducting a cost-effectiveness analysis of imaging as a tool used in colorectal cancer screening would have a significant impact in healthcare of many individuals. Making policies based on the findings of the study would promote early detection and recovery of colorectal cancer. bacteria with the hope of restoring colon health. Learning that even with an antibiotic treatment, 10% to 30% of patients will experience a recurrence of CDI, with the risk approaching 60% after the third episode (Kao et al., 2017). In a noninferiority, unblinded, randomized trial conducted in Alberta, Canada, adult patients with recurrent CDI were randomly assigned to fecal microbiota transplantation (FMT) by capsule or by colonoscopy at a 1:1 ratio by computer-generated random numbers in blocks of 4, stratified by age, and immunosuppression (Kao et al., 2017). Participants took Vancomycin at 125 mg by mouth 4 times a day for 10 or more days until symptom resolution, then treated with vancomycin at 125 mg by mouth twice a day until 24 hours prior to FMT (Kao et al., 2017). Patients randomized to the colonoscopy group received 360mL of a fecal slurry in the cecum and those randomized to the capsule group swallowed 40 capsules under direct observation (Kao et al., 2017). Stool samples were collected and frozen at −80°C prior to FMT and at 1, 4, and 12 weeks after FMT (Kao et al., 2017). Among the remaining patients, the absence of recurrent CDI was achieved in 96.2% of patients, both in the capsule group and the colonoscopy group after a single treatment (Kao et al., 2017). According to Kao et al. (2017), “the cost of administering FMT via colonoscopy was CAD $1120 (US $874) per patient. In comparison, the cost of administering FMT by capsule was CAD $395 (US $308) per patient”. FMT via oral capsules was proven to be an effective innovative treatment for preventing recurrent infection over 12 weeks. Reference Kao, D., Roach, B., Silva, M., Beck, P., Rioux, K., Kaplan, G. G., & ... Wong, G. K. (2017). Effect of oral capsule- vs colonoscopy-delivered fecal microbiota transplantation on recurrent Clostridium difficile infection: A randomized clinical trial. JAMA: Journal of The American Medical Association, 318(20), 1985. doi:10.1001/jama.2017.17077 WEEK 7 HEALTHCARE TOPIC DEBATE RESPONSE TO PEER PPT: Staffing: The Great Debate Transcript Martha, I enjoyed reviewing your PPT and reading your transcript on achieving quality patient care with optimal nurse staffing levels. Nurse staffing is a crucial health policy issue on which there is a great deal of consensus that nurses are an important component of the health care delivery system and that nurse staffing has an impact on patient safety. Research findings about the association between nursing staffing and patient outcome have been inconclusive. In 2004, California became the first state to implement minimum nurse-to-patient staffing ratios, designed to improve patient care and nurse retention. The staffing law in California has been in effect for more than 14 years, but researchers have not found evidence of quality improvement associated with the legislation (Mark, Harless, Spetz, Reiter, Pink, 2013). The quality of care that nurses provide is influenced by individual nurse characteristics such as knowledge and experience, as well as human factors such as fatigue. The quality of care is also influenced by the systems nurses’ work in, which involve not only staffing levels, but also the needs of all the patients a nurse or nursing staff is responsible for, the availability and organization of other staff and support services, and the climate and culture created by leaders in that setting. Reference Mark, B. A., Harless, D. W., Spetz, J., Reiter, K. L., & Pink, G. H. (2013). California’s minimum nurse staffing legislation: Results from a natural experiment. Health Services Research, 48(2 Pt 1), 435–454. PROFESSOR POST TO NURSE STAFFING PPT: Class, Who should determine what is "correct" staffing? RESPONSE TO PROFESSOR POST: Professor Poirier and classmates, The argument for better nurse staffing has led to federal and state regulatory requirements. The Center for Medicare & Medicaid Services requires Medicare-participating hospitals to have adequate numbers of licensed RNs, licensed practical (vocational) nurses, and other personnel to provide nursing care to all patients as needed (ANA, 2015). Although this regulation addresses staffing, it’s open to a wide range of interpretations because it doesn’t quantify “adequate.” There is no benchmark that exists for which all hospitals can claim they’re providing adequate nursing care. To promote continuous appropriate staffing, organizations optimally should use a consistent and standardized structure. In some states, healthcare organizations and units are required to have a staffing plan or committee. A staffing committee oversees the process and gives input on unit scheduling, staffing policies, and procedures (Blankenhorn, 2018). Nurse staffing committees are composed of both nursing management and direct care RNs who realize that all hospitals and nursing professionals are responsible for promoting the health and safety of those in their care. Reference American Nurses Association. (2015). Nurse staffing. Retrieved on August 25, 2018, from Blankenhorn. A. (2018). Staffing committees: A safe staffing solution that includes engagement. Retrieved on August 25, 2018, from