The Cost-Quality Relationship: Evidence from Ontario Complex Continuing Care
- Presenter:
Chair: Edward Norton; Discussant: Melinda Beeuwkes Buntin Wed June 7, 2006 8:00-9:30 Room 325
The relationship between cost and quality in long-term care has not been carefully explored, yet policy is often made based on assumptions about this relationship. This research examines the relationship between cost performance (cost per weighted patient day) and four quality indicators in Ontario Complex Continuing Care hospital beds. We used five years of data from 99 Ontario facilities from the period 1996 through 2000. Facilities were stratified into high and low categories of cost and quality using quartiles of the indicator distributions. These distributions revealed a marked variability in both cost and quality. Cross-sectional and pooled time-series analyses were also conducted. Over time, cost and quality performance showed a high degree of serial correlation. Reduced costs were associated with lower pressure ulcer prevalence with lower incidence of bladder incontinence, while high costs were associated with high quality assessed as a lower pressure ulcer incidence rate. There was no significant relationship between costs and pain management, prevalence of incontinence, antipsychotic use or the use of physical restraints. The analyses to date indicate opportunities for facilities to improve both cost and quality performance in pressure ulcer management and incontinence care.
