Determining the cost-effectiveness of hospital nursing interventions for patients undergoing a total hip replacement


  • Mikyoung Lee PhD, RN,

    Assistant Professor, Corresponding author
    1. Indiana University School of Nursing, Indianapolis, Indiana, USA
    • Correspondence

      Mikyoung Lee

      Indiana University School of Nursing

      1111 Middle Drive

      NU W405


      Indiana 46202



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  • Sue Moorhead PhD, RN,

    Associate Professor, Director
    1. Center for Nursing Classification & Clinical Effectiveness, The University of Iowa College of Nursing, Iowa City, Iowa, USA
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  • Thomas Clancy PhD, RN

    Clinical Professor, Assistant Dean
    1. Faculty Practice, Partnerships and Professional Development, University of Minnesota School of Nursing, Minneapolis, Minnesota, USA
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The purposes of the study were to (i) identify the types and amounts of nursing interventions and (ii) estimate the cost-effectiveness of nursing interventions for complications the patients experienced when undergoing a total hip replacement (THR).


There has been little cost-effectiveness research into nursing interventions in hospitals, resulting in an inability to explain the economic value of hospital nursing interventions.


The direct effects of nursing interventions on hospital direct costs and complication rates were analysed using path modelling, controlling for multiple factors (patient characteristics and nursing contexts) influencing nursing care. Then, cost-effectiveness ratios and the cost-effectiveness plane were used to identify cost-effective interventions.


Intramuscular (IM)/Subcutaneous (SC) Administration was the most cost-effective nursing intervention, followed by Orthotics Management.


The study findings can be used to promote nurses' knowledge and attitudes about the economic value of nursing and cost-effective care delivery. A sensitivity analysis with actual cost per nursing intervention and for specific complications will be necessary.

Implications for nursing management

It is important for nurse administrators to support nurses' clear documentation in order to make nursing information available. Utilizing study methods and findings, nurse managers can compare the cost-effectiveness of new nursing interventions or manage dosages of nursing interventions to provide the most cost-effective nursing interventions.