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BMC Health Services Research

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Open Access 01-12-2005 | Research article

Cost-effectiveness of recommended nurse staffing levels for short-stay skilled nursing facility patients

Authors: David A Ganz, Sandra F Simmons, John F Schnelle

Published in: BMC Health Services Research | Issue 1/2005

Abstract

Background

Among patients in skilled nursing facilities for post-acute care, increased registered nurse, total licensed staff, and nurse assistant staffing is associated with a decreased rate of hospital transfer for selected diagnoses. However, the cost-effectiveness of increasing staffing to recommended levels is unknown.

Methods

Using a Markov cohort simulation, we estimated the incremental cost-effectiveness of recommended staffing versus median staffing in patients admitted to skilled nursing facilities for post-acute care. The outcomes of interest were life expectancy, quality-adjusted life expectancy, and incremental cost-effectiveness.

Results

The incremental cost-effectiveness of recommended staffing versus median staffing was $321,000 per discounted quality-adjusted life year gained. One-way sensitivity analyses demonstrated that the cost-effectiveness ratio was most sensitive to the likelihood of acute hospitalization from the nursing home. The cost-effectiveness ratio was also sensitive to the rapidity with which patients in the recommended staffing scenario recovered health-related quality of life as compared to the median staffing scenario. The cost-effectiveness ratio was not sensitive to other parameters.

Conclusion

Adopting recommended nurse staffing for short-stay nursing home patients cannot be justified on the basis of decreased hospital transfer rates alone, except in facilities with high baseline hospital transfer rates. Increasing nurse staffing would be justified if health-related quality of life of nursing home patients improved substantially from greater nurse and nurse assistant presence.

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The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/5/35/prepub

Title: Cost-effectiveness of recommended nurse staffing levels for short-stay skilled nursing facility patients
Authors: David A Ganz
Sandra F Simmons
John F Schnelle
Publication date: 01-12-2005
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2005
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/1472-6963-5-35

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cost-effectiveness of recommended nurse staffing levels for short-stay skilled nursing facility patients

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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