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cost effectiveness, cluster randomized clinical trial, pain management, rural health



  1. Bensink, Mark E.
  2. Eaton, Linda H.
  3. Morrison, Megan L.
  4. Cook, Wendy A.
  5. Curtis, R. Randall
  6. Gordon, Deborah B.
  7. Kundu, Anjana
  8. Doorenbos, Ardith Z.


Background: With ever-increasing pressure to reduce costs and increase quality, nurses are faced with the challenge of producing evidence that their interventions and care provide value. Cost effectiveness analysis (CEA) is a tool that can be used to provide this evidence by comparative evaluation of the costs and consequences of two or more alternatives.


Objectives: The aim of this article is to introduce the essential components of CEA to nurses and nurse researchers with the protocol of a recently funded cluster randomized controlled trial as an example.


Methods: This article provides (a) a description of the main concepts and key steps in CEA and (b) a summary of the background and objectives of a CEA designed to evaluate a nursing-led pain and symptom management intervention in rural communities compared with the current usual care.


Discussion: As the example highlights, incorporating CEA into nursing research studies is feasible. The burden of the additional data collection required is offset by quantitative evidence of the given intervention's cost and impact using humanistic and economic outcomes. At a time when U.S. healthcare is moving toward accountable care, the information provided by CEA will be an important additional component of the evidence produced by nursing research.