• Peter Callery, Richard G Kyle, Helen Weatherly, Michele Banks, Carol Ewing, Peter Powell, and Susan Kirk.
• School of Nursing, Midwifery and Social Work, The University of Manchester, Manchester Academic Health Science Centre, , Manchester, UK.
• Emerg Med J. 2013 Dec 1;30(12):1029-32.

ObjectiveTo compare the costs associated with care by two community children's nursing teams (CCNT).DesignA case study incorporating questionnaire survey, analysis of routinely collected data and analysis of costs in the north-west England.PatientsChildren with acute illness referred for CCNT care.InterventionsTwo CCNT provided care for 273 children during acute illness in order to reduce the number and duration of hospital admissions.Main Outcome MeasuresCosts of CCNT, other services and costs to families.ResultsThe objectives of both CCNT included shortening and avoiding hospitalisations. Most (45 (58%) in case A and 150 (77%) in case B) children were referred for infections. There were differences in the proportion of children who had been hospitalised (45 (57.7%) and 78 (40%)), the mean number of services used before referral to CCNT (1.6 and 2.2) and the staffing profile of the CCNT. There was a statistically significant difference in the overall mean cost to the NHS of CCNT care (£146 and £238, 95% CI for difference of means 7 to 184), associated with higher proportions of children having telephone-only contact (two (3%) and 46 (24%)) and children using almost twice as many other health services during care by one CCNT (means 0.27 and 0.51).ConclusionsCosts of CCNT care can vary widely when all health service use is taken into account. Differences in the way CCNT are integrated with the urgent care system, and the way in which CCNT care is organised, could contribute to variations in costs.

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