Nursing Economics最新文献

Using a sample of 18,152 pediatric hospice patients, this study assessed the cost-effectiveness of concurrent care over standard hospice care. Analysis of incremental cost-effectiveness ratios with bootstrapping simulations showed that concurrent care was more effective but at a higher cost.

Globally, advanced practice nurses (APNs) provide high-quality chronic disease care to patients, yet the cost-effectiveness of their services is minimally explored. This review aims to determine the cost-effectiveness of chronic disease care provided by APNs compared to physicians globally.

Primary care providers, including physicians and nurse practitioners, described the importance of increased RN staffing in primary care. Adequate RN staffing improves the quality and safety of patient care, alleviates provider workload, and increases care continuity in primary care practices.

With an aging nursing workforce and rising patient acuity levels, healthcare institutions are challenged to meet the demand for competent nursing care Swedish Medical Center (SMC) adopted an aggressive approach for building a new graduate residency program to promote new graduates' opportunity to tap into the valuable expert knowledge and wisdom of retiring nurses. Nursing leadership chose to take an unorthodox approach by identifying new graduates as their hires of choice, citing the ability to create and influence the values and professional practice of the novice nurse as a desired advantage. The program's success focused on adding three key elements to the traditional 1:1 preceptor support model: cohort hiring, monitoring progression to competence, and simulation. SMC is confident this strategy for workforce succession planning will continue to be successful both financially and with regard to patient care quality.

Upon implementation of the Affordable Care Act (ACA), many managed care organizations (MCOs) initially increased their nurse practitioner (NP) contracting. This trend has not continued, potentially frustrating ACA efforts to expand primary care provider capacity. In this study, about 25% of the responding MCOs did not contract with NPs as primary care providers. only 62.5% of respondent MCOs offering Medicaid products reported contracting with NPs as primary care providers, suggesting this will place a disproportionate burden on low-income patients seeking to access care. Findings from this study also have important geographic implications, suggesting the decision to contract with NPs is made individually, not necessarily influenced by the numbers of newly insured or available primary care physicians.

The nation is struggling with the challenges and inefficiencies in the current healthcare environment, the increased demand for primary care services, and growing shortage of primary care providers to meet that demand. Although nurse practitioners (NPs) are highly educated, licensed, and certified healthcare professionals who are qualified to provide primary care services, the restrictive policies for physician oversight that exist in many states impede full utilization of the skills possessed by NPs in primary care provider roles. NPs are a crucial part of the solution to the growing demands for primary care in the United States and the transformation of the healthcare system to one in which accessible, patient-centered, essential health services are provided while improving the quality of care and controlling healthcare costs.

Multiple national reports identify actionable recommendations to transform education and practice to meet the needs of health care and healthcare delivery beyond the hospital walls. The Josiah Macy Jr. Conference (2016) focused on transforming primary care and changing healthcare culture to support expansion of roles for registered nurses (RNs). Partnerships between academia and clinical practice are critical to expanding learning opportunities beyond traditional acute care settings. Development of primary care expertise in nursing faculty and adjunct faculty, in collaboration with primary care and ambulatory care nursing leaders, is essential. Academic-practice partnerships must advocate for removing regulatory and practice barriers to allow RNs to practice to the full scope of education and training. Recommendations from national reports extend beyond enhanced roles in primary care practice and have global implications for all RNs practicing in ambulatory care.

Globally, an estimated 25% of individuals suffer from mental disorders. Approximately 50% of Americans will experience mental disorders in their lifetime. The cost of this U.S. mental health crisis is estimated at $444 billion per year when lost economic productivity is included, with only about one-third of the total dollars going to care itself. The generalist RN workforce is an untapped resource and invaluable health provider choice, uniquely suited to make an economic difference to the U.S. healthcare system by improving access, lowering costs, and improving quality of behavioral health care.

Each year millions of people are readmitted to hospitals across the nation; many of these readmissions are preventable. Successful care coordination and transition management strategies are critical steps needed to meet Partnership for Patients goals of reducing harm and improving the quality and safety of health care. Decreasing variance in healthcare delivery can improve quality, safety, and improve patient outcomes. Project Re-Engineered Discharge shows promise as an evidence-based, standardized approach to address preventable hospital readmissions.

In October 2016, the State of Vermont signed an unprecedented agreement (The All-Payer Accountable Care Model) with the Federal Government to completely reform how health care is delivered and paid for in Vermont. This innovative agreement builds on sweeping 2011 legislation that set Vermont on a course towards payment reform designed to eliminate the fragmentation, overtreatment, and high costs associated with fee-for-service reimbursement. The strong emphasis on care coordination, preventative care, the patient experience, and population health ensures a crucial and growing role for nurses in this innovative environment and provides a model to inform the nation. Such state-led reform may have particular importance during the Trump administration, given the expected emphasis on state's rights and state leadership.