title: A survey of perceived benefit and differences in therapy provided by credentialed and noncredentialed nutrition support dietitians.
abstract: BACKGROUND
  Benefits of the certified nutrition support dietitian (CNSD) credential to clinicians, their patients, and healthcare administrators have not been defined. A study was designed to measure the difference in cost of therapy provided by credentialed and noncredentialed nutrition support dietitians and to measure the perceived value of the credential to those who hold it.
  
  
  METHODS
  Using a modified Delphi technique, a questionnaire was developed to obtain demographic information, responses to statements of perceived benefit of the credential, and costs of therapy selected for patients in common clinical scenarios.
  
  
  RESULTS
  Of the 691 questionnaires mailed, 314 (45%) were returned. For 8 of 10 statements of perceived benefit, mean response scores indicated agreement. Respondents did not agree that salary increases resulted from credentialing. There was no difference between groups in the type of monitoring selected or in the time to complete an initial assessment. Cost of therapy was significantly higher for credentialed versus noncredentialed dietitians (dollar 915.67 +/- dollar 241.73 versus dollar 851.78 +/- dollar 243.44; p = .035), although the survey was not designed to show that the most appropriate care was least expensive.
  
  
  CONCLUSIONS
  The CNSD credential is of perceived benefit to practitioners except in obtaining salary increases. Credentialed dietitians selected more expensive therapy than noncredentialed dietitians, which would benefit healthcare administrators only if reduction of other costs resulted. More complex models are needed to fully assess the benefit of credentialed nutrition support dietitians to patients and healthcare administrators.
authors.affiliation: Department of Clinical Nutrition, Rush University, Chicago, Illinois 60612, USA.
authors.forename: Janet Furman
authors.initials: JF
authors.lastname: Simmons
authors.forename: Annalynn
authors.initials: A
authors.lastname: Skipper
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Lafferty
authors.forename: Mary B
authors.initials: MB
authors.lastname: Gregoire
mesh_terms: D002568:Certification; D003406:Credentialing; D004046:Dietetics / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D018529:Nutritional Support / Q000191:economics; D010465:Perception; D012456:Salaries and Fringe Benefits; D011795:Surveys and Questionnaires