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    Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up

    Access Status
    Fulltext not available
    Authors
    Miller, Ted
    Hendrie, Delia
    Date
    2015
    Type
    Journal Article
    
    Metadata
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    Citation
    Miller, T. and Hendrie, D. 2015. Nurse Family Partnership: Comparing Costs per Family in Randomized Trials Versus Scale-Up. Journal of Primary Prevention. 36: pp. 419-425.
    Source Title
    Journal of Primary Prevention
    DOI
    10.1007/s10935-015-0406-3
    ISSN
    0278-095X
    School
    Centre for Population Health Research
    URI
    http://hdl.handle.net/20.500.11937/17984
    Collection
    • Curtin Research Publications
    Abstract

    The literature that addresses cost differences between randomized trials and full-scale repli- cations is quite sparse. This paper examines how costs differed among three randomized trials and six statewide scale-ups of nurse family partnership (NFP) intensive home visitation to low income first- time mothers. A literature review provided data on pertinent trials. At our request, six well-established programs reported their total expenditures. We adjusted the costs to national prices based on mean hourly wages for registered nurses and then inflated them to 2010 dollars. A centralized data system provided utilization. Replications had fewer home visits per family than trials (25 vs. 31, p = .05), lower costs per client ($8860 vs. $12,398, p = .01), and lower costs per visit ($354 vs. $400, p = .30). Sample size limited the significance of these differences. In this type of labor intensive program, costs probably were lower in scale-up than in randomized trials. Key cost drivers were attrition and the stable caseload size possible in an ongoing program. Our estimates reveal awide variation in cost per visit across six state programs, which suggests that those planning replications should not expect a simple rule to guide cost estimations for scale-ups. Nevertheless, NFP replications probably achieved some economies of scale.

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