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

Roberts, N.J., Boyd, K. , Briggs, A.H. , Caress, A.L. and Partridge, M.R. (2012) Nurse led versus lay educators support for those with asthma in primary care: a costing study. BMC Pulmonary Medicine, 12(52), (doi:10.1186/1471-2466-12-52)

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Abstract

<p>Background - Regular 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.</p> <p>Methods - Following 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.</p> <p>Results - One 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).</p> <p>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]).</p> <p>Conclusions - There 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.</p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Briggs, Professor Andrew and Boyd, Dr Kathleen
Authors: Roberts, N.J., Boyd, K., Briggs, A.H., Caress, A.L., and Partridge, M.R.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
Journal Name:BMC Pulmonary Medicine
Publisher:BioMed Central
ISSN:1471-2466
Published Online:08 September 2012
Copyright Holders:Copyright © 2012 The Authors
First Published:First published in BMC Pulmonary Medicine 12:52
Publisher Policy:Reproduced under a Creative Commons License

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