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The Impact of a Skilled Nursing Facility on the Cost of Surgical Treatment of Major Head and Neck Tumors
Hadi Seikaly, MD, FRCSC;
Karen H. Calhoun, MD;
Jana S. Stonestreet, RN, MSN;
Christopher H. Rassekh, MD;
Brian P. Driscoll, MD;
Phylis Averyt, CPA
Arch Otolaryngol Head Neck Surg. 2001;127:1086-1088.
Background The finite resources available for health care and the proliferation
of managed care in the United States have forced the head and neck surgeon
to critically evaluate the cost of tumor treatment.
Objective To determine whether the cost of treating patients with head and neck
tumors would be reduced if the patients were to spend a portion of what would
otherwise be acute care hospital days in a hospital-based skilled nursing
facility (HB/SNF).
Design Retrospective cost-benefit analysis.
Setting Tertiary referral center.
Patients Twenty-four consecutive hospital admissions for definitive surgical
treatment of head and neck tumors were retrospectively reviewed. The postoperative
day on which the patient theoretically could have been transferred to the
HB/SNF was determined. The charges and cost of each patient's actual hospital
stay were compared with the theoretical counterparts had the patient been
transferred to the HB/SNF on the determined day.
Main Outcome Measure Cost savings.
Results The total hospital stay for the 24 patients was 524 days. One hundred
eighty-two of those days could have been spent in the HB/SNF. The total charge
and cost savings with the use of an HB/SNF were $201 045 and $84 238,
respectively (15% of the total charge and cost). This represents an average
charge and cost savings of $8377 and $3510, respectively, per patient. The
difference was statistically significant (P<.005).
Conclusion An HB/SNF could reduce the cost of head and neck tumor treatment without
compromising patient care.
From the Division of Otolaryngology–Head and Neck Surgery, University
of Alberta, Edmonton (Dr Seikaly); the Departments of Otolaryngology–Head
and Neck Surgery (Drs Calhoun and Driscoll), Clinical Affairs (Ms Stonestreet),
and Healthcare Financial Management (Ms Averyt), University of Texas Medical
Branch, Galveston; and the Department of Otolaryngology–Head and Neck
Surgery, University of West Virginia, Morgantown (Dr Rassekh).
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Archives of Otolaryngology–Head & Neck Surgery Reader's Choice: Continuing Medical Education
Arch Otolaryngol Head Neck Surg. 2001;127(9):1146-1148.
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