title: The impact of a skilled nursing facility on the cost of surgical treatment of major head and neck tumors.
abstract: 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).
  
  
  METHODS
  Retrospective cost-benefit analysis.
  
  
  METHODS
  Tertiary referral center.
  
  
  METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  An HB/SNF could reduce the cost of head and neck tumor treatment without compromising patient care.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Office 401, 11044-82 Ave, Edmonton, Alberta, Canada T6G 0T2. hseikaly@powersurfr.com
authors.forename: H
authors.initials: H
authors.lastname: Seikaly
authors.forename: K H
authors.initials: KH
authors.lastname: Calhoun
authors.forename: J S
authors.initials: JS
authors.lastname: Stonestreet
authors.forename: C H
authors.initials: CH
authors.lastname: Rassekh
authors.forename: B P
authors.initials: BP
authors.lastname: Driscoll
authors.forename: P
authors.initials: P
authors.lastname: Averyt
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D006258:Head and Neck Neoplasms / Q000191:economics* / Q000601:surgery*; D017048:Health Care Costs / Q000706:statistics & numerical data*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D008297:Male; D010360:Patient Transfer / Q000191:economics; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities / Q000191:economics*; D019467:Subacute Care / Q000191:economics; D014481:United States