The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence
Background: Patients with palliative care (PC) needs do not access specialist palliative care services according to their necessities. Clinical Nurse Specialists (CNS) working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited kno...
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| Format: | Article |
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SAGE
2017
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| Online Access: | https://eprints.nottingham.ac.uk/43621/ |
| _version_ | 1848796730713178112 |
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| author | Salamanca-Balen, Natalia Seymour, Jane Caswell, Glenys Whynes, David Tod, Angela |
| author_facet | Salamanca-Balen, Natalia Seymour, Jane Caswell, Glenys Whynes, David Tod, Angela |
| author_sort | Salamanca-Balen, Natalia |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Patients with palliative care (PC) needs do not access specialist palliative care services according to their necessities. Clinical Nurse Specialists (CNS) working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited knowledge of the extent to which their interventions are cost-effective.
Objectives: To present results from a systematic review of the international evidence on the costs, resource use and cost effectiveness of CNS led interventions for patients palliative care needs, defined as seriously ill patients and those with advanced disease or frailty who are unlikely to be cured, recover, or stabilize.
Design: Systematic review following PRISMA methodology.
Data sources: Medline, Embase, Cinahl and Cochrane library up to 2015. Studies focusing on the outcomes of CNS interventions for patients with PC needs, and including at least one economic outcome, were considered. The quality of studies was assessed using tools from the Joanna-Briggs-Institute.
Results: A total of 79 papers were included: 37 RCTs, 22 quasi-experimental studies, 7 service evaluations and other studies, and 13 economic analyses. The studies included a wide variety of interventions including clinical, support and education, as well as care coordination activities. The quality of the studies varied greatly.
Conclusions: CNSs interventions may be effective in reducing specific resource use such as hospitalizations /re-hospitalizations/admissions, length of stay, and health care costs. There is mixed evidence regarding their cost-effectiveness. Future studies should ensure that clinical nurse specialists’ roles and activities are clearly described and evaluated. |
| first_indexed | 2025-11-14T19:52:38Z |
| format | Article |
| id | nottingham-43621 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:52:38Z |
| publishDate | 2017 |
| publisher | SAGE |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-436212020-05-04T18:47:13Z https://eprints.nottingham.ac.uk/43621/ The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence Salamanca-Balen, Natalia Seymour, Jane Caswell, Glenys Whynes, David Tod, Angela Background: Patients with palliative care (PC) needs do not access specialist palliative care services according to their necessities. Clinical Nurse Specialists (CNS) working across a variety of fields are playing an increasingly important role in the care of such patients, but there is limited knowledge of the extent to which their interventions are cost-effective. Objectives: To present results from a systematic review of the international evidence on the costs, resource use and cost effectiveness of CNS led interventions for patients palliative care needs, defined as seriously ill patients and those with advanced disease or frailty who are unlikely to be cured, recover, or stabilize. Design: Systematic review following PRISMA methodology. Data sources: Medline, Embase, Cinahl and Cochrane library up to 2015. Studies focusing on the outcomes of CNS interventions for patients with PC needs, and including at least one economic outcome, were considered. The quality of studies was assessed using tools from the Joanna-Briggs-Institute. Results: A total of 79 papers were included: 37 RCTs, 22 quasi-experimental studies, 7 service evaluations and other studies, and 13 economic analyses. The studies included a wide variety of interventions including clinical, support and education, as well as care coordination activities. The quality of the studies varied greatly. Conclusions: CNSs interventions may be effective in reducing specific resource use such as hospitalizations /re-hospitalizations/admissions, length of stay, and health care costs. There is mixed evidence regarding their cost-effectiveness. Future studies should ensure that clinical nurse specialists’ roles and activities are clearly described and evaluated. SAGE 2017-05-28 Article PeerReviewed Salamanca-Balen, Natalia, Seymour, Jane, Caswell, Glenys, Whynes, David and Tod, Angela (2017) The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence. Palliative Medicine . pp. 1-19. ISSN 1477-030X Economics Cost-effectiveness cost-benefit analysis health care costs health resources clinical nurse specialist CNS frail elderly palliative care advanced disease http://journals.sagepub.com/doi/10.1177/0269216317711570 doi:10.1177/0269216317711570 doi:10.1177/0269216317711570 |
| spellingShingle | Economics Cost-effectiveness cost-benefit analysis health care costs health resources clinical nurse specialist CNS frail elderly palliative care advanced disease Salamanca-Balen, Natalia Seymour, Jane Caswell, Glenys Whynes, David Tod, Angela The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence |
| title | The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence |
| title_full | The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence |
| title_fullStr | The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence |
| title_full_unstemmed | The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence |
| title_short | The costs, resource use, and cost-effectiveness of Clinical Nurse Specialist (CNSs) led interventions for patients with palliative care needs: a systematic review of international evidence |
| title_sort | costs, resource use, and cost-effectiveness of clinical nurse specialist (cnss) led interventions for patients with palliative care needs: a systematic review of international evidence |
| topic | Economics Cost-effectiveness cost-benefit analysis health care costs health resources clinical nurse specialist CNS frail elderly palliative care advanced disease |
| url | https://eprints.nottingham.ac.uk/43621/ https://eprints.nottingham.ac.uk/43621/ https://eprints.nottingham.ac.uk/43621/ |