Clinical Economics and Nursing

Perceptions of Health Professionals on Concepts Clinical Economics and Patient Advocate

“…According to the above, it should be noted that the author of the terms directs the use of the terms mainly for the hospital environment, but is not limited to it. And, when addressing the financial aspect of health institutions and services, it is not limited to discussing private ones (8) .…”

Development of the nursing profession: From nursing angel to patient advocate

“…The Y-nurse is a highly trained and experienced professional, designated by management but answering only to the executive director, who is recognized as a scientific authority for optimizing health care, and who is paid appropriately. [21,22] The continuation of CLINECS studies resolved that the most appropriate terminology for what was initially designated as the Y-Nurse would be "Patient Advocate", in accordance with the nature and objectives of this new professional category. The "Patient Advocate", after evaluation of the health team's decisions, is the one who compares the efforts employed with the outcomes, identifying the best outcome for the patient under the CLINECS concept, and recommending changes aimed at excellence in health care delivery (see Table 1) based on Padilha et al (2013) [23] and Planas-Campmany, Icart-Isern (2014).…”

“…[24] In order to respond as a "Patient Advocate" it is desirable to have solid undergraduate training in epidemiology, statistics, the management of health services, evidence-based decisionmaking, and experience and clinical knowledge in the specialty. [22] The work of the "Patient Advocate" is aimed at producing the best health care possible, observing lower costs of resources, particularly those which affect the patient's quality of life, and identifying and questioning the team's decisions which are not supported by the principles of clinical economics.…”

“…In this scope, the patient's perspective is considered, which is a fundamental requirement of the concept; CLINECS means applying economic principles to the health services-with the caveat that the meaning of the word "economic" is not employed in the sense of gaining profit. [22] For example, a complete economic analysis includes three parts: 1) "costs", that is, what is necessary to accept, such as hospitalization, side effects, a treatment's risks, or monetary costs; 2) "consequences", that is, the return, the solution to one's health problem; and 3) "alternative forms of actions", which means that the patient always has to compare the costs and the consequences of at least two or more possible actions.…”

“…In contrast, a commercial decision means making profit, generally monetary profit for one's own pocket or for a company. [22] Based on CLINECS, it has been discussed that health care is the responsibility of a team of professionals, including politicians, physicians, and nurses among others, with it not being appropriate to indicate a scale of hierarchical importance.…”