cost effectiveness Archives

Nurses Week: Time to Celebrate (Not Denigrate) Nursing’s Worth

By Maureen Shawn Kennedy, AJN editor-in-chief

So, on the cusp of Nurses Week, the week when Americans are encouraged to think about the value that nurses bring to health care, readers of the New York Times were treated to an op-ed written by physician Sandeep Jauhar. According to the byline, Jauhar is a cardiologist and the author of an upcoming memoir about his disillusionment as a physician. The title of the piece was “Nurses Are Not Doctors.” While the author makes sure to reassure us that he thinks nurse practitioners (NPs) have a valuable role to play in health care, he makes the usual charge that NPs are not qualified to practice primary care without physician supervision.

Jauhar conveniently ignores the many studies that have refuted this argument, while basing his case largely on weak anecdotes and one study from 1999 that showed NPs ordered more diagnostic tests. His conclusion: the NPs in the study ordered too many expensive tests because they lack the experience and knowledge of physicians (he concedes in passing that “there are many reasons the NPs may have ordered more tests”). I can’t help thinking that this piece’s publication was purposely timed to take some of the shine off Nurses Week.

I’m surprised that the Times published such a weak letter. First, […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-03-28T10:24:54-04:00May 5th, 2014|career, nursing perspective, nursing research|4 Comments

Improve health, reduce costs: that’s the mantra health care reform advocates keep repeating. And it’s easy to see why: this year, total health care spending in the United States is expected to reach $2.5 trillion, accounting for almost 18% of the gross domestic product. By 2018 the total could be $4.4 trillion-and because economic growth is expected to be slower over this period, that total may account for one-fifth of the gross domestic product in 2018. And even with all of this spending, the United States lags behind other industrialized nations on many measures of health and well being.

While there are many paths to achieving the twin goals of better outcomes and lower costs, a consensus has been growing among health policy experts and economists that part of the solution is to improve the way medical research is conducted and then put it into practice in both providers’ and consumers’ decision making. Comparative effectiveness research (CER)-a model by which cost-benefit analyses of different treatments for a given condition are compared-provides the means for understanding which interventions yield the best health outcomes for the least amount of money.

Read the rest of the article in the October issue of AJN here. With something so complex, life altering, and expensive as health care, how could we not expect to do a little comparative shopping about cost and quality?