Methodological issues in linking costs and health outcomes in research on differing care delivery systems

Abstract

Objectives: This article discusses, from an economist's point of view, issues in designing and conducting research including cost and outcomes variables among differing care delivery systems.

Methods: Issues were identified, and selected research purporting to link cost and outcomes with variations in care delivery systems was reviewed.

Results: Current literature on nursing care delivery systems and costs in hospitals, ambulatory care, and nursing homes is focused mainly on group-specific costs linked to patient-specific outcomes. It suffers further from focusing primarily on single-discipline components of care, omitting the contributions of other providers beyond nursing personnel.

Conclusions: Multidisciplinary teams, including economists who can speak clinical language, are recommended.