Increasing Cardiomyopathy Screening in Childhood Cancer Survivors: A Cost Analysis of Advanced Practice Nurse Phone Counseling.
Cheryl L Cox, M Robyn Andersen, Aimee K Santucci and 2 others
PMID 27768131WHAT IT FOUND
Advanced practice nurse phone counseling added to a mailed survivorship care plan raised cardiomyopathy screening from 22.3% to 52.2%.
In modeled clinic scenarios, counseling cost less per additional survivor screened than care plan alone.
Key findings
01Adding advanced practice nurse phone counseling to a mailed survivorship care plan increased completion of left ventricular function screening from 22.3% to 52.2%.
02In the trial cost model, per-survivor costs were $74.91 for care plan alone and $224.69 for care plan plus counseling, with costs per survivor screened of $340.50 and $432.10, respectively.
03In modeled dissemination clinics, counseling cost less per additional survivor screened than care plan alone: $293.85 vs $345.41 in a medium clinic and $264.54 vs $337.59 in a larger clinic.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cost estimates came from a single institution and may not match other clinics' salaries, supplies, or workflow. The analysis included assumptions about clinic size, program length, and which costs were counted, so the modeled savings may not transfer directly. The screening effect came from a trial of adult childhood cancer survivors in a specific survivorship cohort, so it may not apply to survivors outside that cohort or to other screening programs. Survivors were not treated at the institution delivering the counseling and depended on primary care physicians to order screening, which may limit generalizability. The tested intervention used advanced practice nurses, so applicability to other staff is not demonstrated.
Declared interests
The supplied text does not include an author conflicts-of-interest declaration; publication types indicate NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that nurse phone counseling is always cheaper than a printed care plan. In the trial cost model, counseling cost $432.10 per survivor screened versus $340.50 for care plan alone, and the lower cost per additional survivor screened appeared only in modeled clinic scenarios.