Nurse led versus lay educators support for those with asthma in primary care

a costing study

Nicola J. Roberts, Kathleen A. Boyd, Andrew H. Briggs, Ann L. Caress, Martyn R. Partridge

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.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.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).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]).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.

Original languageEnglish
Article number52
JournalBMC Pulmonary Medicine
Volume12
DOIs
Publication statusPublished - 8 Sep 2012
Externally publishedYes

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Primary Health Care
Asthma
Nurses
Costs and Cost Analysis
Delivery of Health Care
Self Care
Health Care Costs
Referral and Consultation
Randomized Controlled Trials
Guidelines

Cite this

Roberts, Nicola J. ; Boyd, Kathleen A. ; Briggs, Andrew H. ; Caress, Ann L. ; Partridge, Martyn R. / Nurse led versus lay educators support for those with asthma in primary care : a costing study. In: BMC Pulmonary Medicine. 2012 ; Vol. 12.
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Nurse led versus lay educators support for those with asthma in primary care : a costing study. / Roberts, Nicola J.; Boyd, Kathleen A.; Briggs, Andrew H.; Caress, Ann L.; Partridge, Martyn R.

In: BMC Pulmonary Medicine, Vol. 12, 52, 08.09.2012.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nurse led versus lay educators support for those with asthma in primary care

T2 - a costing study

AU - Roberts, Nicola J.

AU - Boyd, Kathleen A.

AU - Briggs, Andrew H.

AU - Caress, Ann L.

AU - Partridge, Martyn R.

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Y1 - 2012/9/8

N2 - 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.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.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).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]).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.

AB - 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.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.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).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]).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.

KW - Asthma

KW - telephone consultation

KW - healthcare utilisation

KW - practice nurse

KW - Scenario analysis

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DO - 10.1186/1471-2466-12-52

M3 - Article

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JO - BMC Pulmonary Medicine

JF - BMC Pulmonary Medicine

SN - 1471-2466

M1 - 52

ER -