The Attitude of Registered Nurses to Integrating Economic Considerations in Medical Care

Presenter: Racheli Magnezi, School of Health Sciences

Abstract

Rationale: Increasing costs of health services oblige the integration of economic considerations in decision making processes by different participants in the healthcare system. With the increasing status as care-takers and expansion of their authority, nurses have to share economic considerations in healthcare as a part of the clinical decision-making team.

Objectives: To assess the attitude of registered nurses toward the integration of economic considerations in the preferances of medical care, and to estimate whether targeted training would improve the decision-making mechnism.

Methodology: A survey of 200 registered nurses was conducted in hospitals in Israel, using a questionnaire that contained questions relating to their attitudes regarding the integration of economic considerations in medical care, as well as demographic details.

Results: 187 nurses (94%) responded to the questionnaire (14% male, 86% female). About one-quarter held managerial positions and three-quarters were clinical nurses whose work entails decision making. Half of the respondents participate in seminars dealing with issuse of health economy,. 77.5% of the nurses replied that economic considerations were justified, 88% felt they would encourage more efficient use of existing resources, and 57.3% stated that supervision and control might lead to cost containment. The reasons for doubting the need for economic considerations were: The threat of professional lawsuits (53%), a fear of decreased patient satisfaction (50%), and a reduction in patients’ trust (49.7%). The nurses indicated that economic considerations should be made by the medical management, control factors and physicians, and only then should nurses be involved in these decisions. About 95% claimed that their current work involves more economic considerations than in the past.

Conclusions: As part of the medical team, it is important for registered nurses to integrate economic consideratins in the decision-making processes of continuous care giving. Targeted education programs in nursing schools and further advanced professional training, would contribute to the reinforcement of professional skills and involvement of nurses in this area.