Cost and Quality

Evidence From Ontario Long Term Care Hospitals

Bibliographic Data

ID9097604
AuthorsWalter P Wodchis (0000-0003-2494-7031, University of Toronto, corresponding author), Georgia Teare (0000-0002-7655-7409, Saskatchewan Health Quality Council, corresponding author), Gary F Teare, Geoff Anderson (Institute for Clinical Evaluative Sciences, corresponding author), Geoff M Anderson
Year2007
Volume45
Issue10
Pages981-988
Publication date2007-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3180ca95e9
PMID17890996
OpenAlexW2009682256
LanguageEN
Citations received1
References cited36

BACKGROUND: Although both quality and cost are important concerns for long term care (LTC) facility management and policy, the relationship between cost and quality is poorly understood. Such knowledge is necessary to guide facility management and policy action. OBJECTIVE: We sought to determine the net effect of quality on cost in LTC hospital settings. STUDY SAMPLE: A 4-year panel dataset from April 1997 through March 2002 comprising observations from 99 LTC hospitals were included in this analysis. METHODS: We examined the relationship between direct resident costs and 7 indicators of quality for long-stay residents. We used panel data methods to control for unobserved facility-level characteristics. RESULTS: We found that increases in restraint use and incident pressure/skin ulcers were associated with lower per diem costs, whereas incontinence prevalence was associated with higher per diem costs. CONCLUSIONS: Our results point to different implications regarding cost and quality for different quality indicators. Although facilities have a strong internal business case to improve quality in incontinence, policy-makers may need to provide financial incentives to encourage reductions in restraint use and incident skin ulcers so as to defray potential higher costs associated with improving quality in these areas

Business · Control (management) · Cost control · Economics · Environmental health · Incentive · Management system · Operations management · Quality (philosophy) · Quality assurance · Quality costs · Quality management · Risk analysis (engineering) · Elder Abuse and Neglect · Geriatric Care and Nursing Homes · Healthcare Decision-Making and Restraints · Marketing · Medicine

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