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

Table 3 Utilities, costs and discount rate

Parameter	Base Case	Biased toward recommended staffing	Biased against recommended staffing	Ref.
Utilities
Hospital	0.73	0.41	[0.79]	[11]
Discharge	0.79	1.00	[0.73]	[11]
Days to reach discharge utility Under recommended staffing*	[30]	[15]	[30]
Hourly wages with benefits
Nurse assistant	$13.28	[$10]	[$20]	[13, 14]
Licensed practical nurse	$20.78	[$30]	[$15]	[13, 14]
Registered nurse	$32.94	[$20]	[$40]	[13, 14]
Other nursing facility costs	$193.5	[$400]	[$100]	[15]
Hospitalization costs
Congestive heart failure**	$4603	[$9206]	[$2301]	[9]
Electrolyte imbalance**	$3913	[$7826]	[$1956]	[9]
Respiratory infection**	$4722	[$9444]	[$2361]	[9]
Sepsis**	$7142	[$14285]	[$3571]	[9]
Urinary tract infection**	$3853	[$7707]	[$1927]	[9]
Daily cost for discharged patients	[$0]	[$0]	$113	[17]
Annual discount rate	3%	0%	5%	[25]

All costs in 2002 U.S. dollars. Brackets refer to assumptions made for sensitivity analyses where data were not available or did not provide an adequate range for the parameter. Base case values represent the best available estimate of the parameter in question. Values listed under the column "biased toward recommended staffing" and "biased against recommended staffing" represent extreme values of the parameter that are most favorable and least favorable to the recommended staffing scenario when tested in sensitivity analyses.
*Number of days in skilled nursing facility required to go from utility at admission to discharge level of 0.79 under recommended staffing. Average staffed facilities were assumed to require 30 days to reach discharge utility level.
**Hospitalization costs were varied together. Hospitalization costs include Medicare reimbursement to the hospital plus initial and subsequent physician visits.

ISSN: 1472-6963