Evaluation of a Nurse Practitioner-Led Care Management Model in Reducing Inpatient Drug Utilization and Cost

The aim of this research was to evaluate the economic impact of a collaborative nurse practitioner (NP) care management model on the use of pharmaceutical resources, with a focus on antibiotics, among general medicine inpatients. Although studies have shown the effectiveness of care management by NPs, especially as reflected on length of stay and hospital cost, little is known about their impact on drug cost. The researchers utilized pharmaceutical claims data of 1,200 subjects who participated in the Multidisciplinary, Physician, and Nurse Practitioner Study from 2000 to 2004 to assess the effect of the NP-led care management model on drug utilization outcomes. Study findings revealed that the intervention group was associated with significant reduction in drug cost and drug utilization; even though the intervention group was more likely to be given broad-spectrum or other antibiotics, its overall drug and antibiotic costs were lower than the control group. Drug management strategies such as de-escalation and intravenous-to-oral conversion facilitated by NPs may potentially produce both clinically and economically advantageous outcomes among general medicine inpatients.