Return-on-investment models.

It is clearly important for businesses and organizations to have accurate measures of the rate of return on investments (ROIs) to guide their investment decisions. In health care, the demographic trends, explosion in high-cost technology, and changing health care system have focused attention on both the costs and the effectiveness of health care services. Total health care costs in the United States have risen for the last 6 years; although growth slowed in 2002, total health care costs are projected to rise from 14.9% of the U.S. gross domestic product in 2002 to 18.4% in 2013 (Heffler et al., 2004). Because of this level of spending, health care executives and decision makers are increasingly interested in economic evaluations (Stone, 2002; Stone, Curran, & Bakken, 2002). Therefore, in an interest to having effective evidence-based nursing interventions adopted into practice, researchers and clinicians may increasingly wish to conduct economic evaluations. Because of this need, in the summer of 2004, in an effort to help nurse researchers better understand these techniques, a 2-day workshop was held by the National Institute of Nursing Research. Expert faculty from the Agency for Healthcare Research and Quality, Johns Hopkins University, and Columbia University provided a series of lectures and breakout sessions to help nurse researchers understand the mechanics of cost–effectiveness analyses. However, there are a number of other types of economic evaluations found in the literature and used in setting policy that may be of interest to nurse researchers (Stone, Bakken, Curran, & Walker, 2002). Table 1 briefly defines the different types of economic evaluations available. In all of these economic outcome evaluations, alternative strategies are compared (i.e., the introduction of a new policy compared with an old policy) and incremental costs of the competing strategies should be computed. The methods differ only in how effects (outcomes) are measured. Return on investment is a type of cost–benefit analysis conducted from investors’ (e.g., the