Evidence map›Paper›PMID 26856495›Full record

ArticleApplied nursing research : ANR2016

Economic evaluation of registered nurse tenure on nursing home resident outcomes.

Mayuko Uchida-Nakakoji, Patricia W Stone, Susan Schmitt, Ciaran Phibbs, Y Claire Wang

Abstract read
In one paragraph

Article in Applied nursing research : ANR, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mayuko Uchida-NakakojiColumbia University School of Nursing, Center for Health Policy at Columbia University Medical Center, New York City, 10032, USA.
Patricia W StoneColumbia University School of Nursing, Center for Health Policy at Columbia University Medical Center, New York City, 10032, USA. Electronic address: ps2024@columbia.edu.
Susan SchmittVA Heath Economics Resource Center, Palo Alto, 94305, USA.
Ciaran PhibbsVA Heath Economics Resource Center, Palo Alto, 94305, USA; Stanford University, Stanford, 94305, USA.
Y Claire WangMailman School of Public Health at Columbia University Medical Center, New York City, 10032, USA.

Funding

Study of Infection Management and Palliative Care at End-of-Life (SIMP-EL)R01NR013687 · NINR · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI STONE, PATRICIA W. · 2012 to 2020
$5.8M
Comparative and Cost Effectiveness Analyses of HAI Reduction in Nursing HomesF31NR013810 · NINR · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI UCHIDA-NAKAKOJI, MAYUKO · 2012 to 2013
$57k
NINR NIH HHS F31 NR013810NINR NIH HHS F31NR013810NINR NIH HHS R01 NR013687NINR NIH HHS R01NR013687
6 · The paper itself

Abstract

purposeLittle is known about the economic implications of nursing home (NH) registered nurse (RN) tenure on resident outcomes. This study evaluated the cost-effectiveness of two nurse workforce scenarios focusing on RN tenure (high versus low), and the associated transfers from NH to the hospital.

methodsA decision tree was constructed to compare the incremental costs and effects of RN tenure scenarios on NH resident transfers to the hospital under two NH staffing scenarios: high versus low levels of RN tenure. Three outcomes were modeled: 1) dollars per hospitalization avoided, 2) dollars per hospitalization and death avoided, and 3) dollars per death avoided.

resultsThe total costs of care for the low tenure scenario were $34,108 per month compared to the high tenure scenario at $29,442 per month. Effectiveness of the high tenure was greater across all 3 outcomes (incremental effectiveness ranged from 0.925 to 0.974 depending on outcome), indicating that high tenure was the dominant strategy (that is less costly and more effective).

conclusionsHigher RN tenure was a dominant strategy across the 3 outcomes. This was a fairly robust finding despite the variations in the model and uncertainty in the input parameters. Aligning quality outcomes with cost effectiveness is imperative to driving the direction of health policy in the United States. Better prevention of hospitalizations by having an experienced RN workforce will not only improve resident quality of care but will allow NHs to realize the value of retaining a skilled workforce.

Indexed as

Cost-Benefit AnalysisNursesNursing HomesUnited StatesCost-effectiveness analysisEconomic evaluationLong-term careNursingVeteransWorkforce

Identifiers

PMID26856495
PMCPMC4748169

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.