206225 Net Costs of a No-Lift Intervention Program in a Large Chain of Nursing Homes

Wednesday, November 11, 2009: 1:30 PM

Supriya Lahiri, Ph D , Department of Economics, University of Massachusetts Lowell, Lowell, MA
Heather Zajac, BA , Department of Economics, University of Massachusetts Lowell, Lowell, MA
Suzanne Nobrega, MS , Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Laura Punnett, ScD , Department of Work Environment, University of Massachusetts Lowell, Lowell, MA
Saira Latif, Ph D , College of Management , Finace Group, University of Massachusetts Lowell, Lowell, MA
Since successful OSH interventions often require substantial investments on the part of the employers, we estimated the net economic costs of investments in a “No-Lift Program,” intended to reduce work-related back morbidity, in a large chain of nursing homes on the East coast. A subset of these centers had also implemented Workplace Wellness Program (WWP) activities.

The net-cost model (Lahiri et al. 2005) provides a transparent framework that incorporates not only the costs of investment in equipment and labor but also the avoided costs of lost work time, and medical care in the post versus pre-intervention period. In our study the net-cost estimates are estimated principally from the employer's perspective. Since the corporation is self-insured, it has a stake in the avoided medical care costs and indemnity of a reduction in injury.

The No-Lift Program was implemented from March 2004 to Sept 2006, center by center. Center costs were compared pre- versus post-intervention for each of 44 centers that had accrued at least 2 years of follow-up post-intervention.

Total annualized net savings equal $1.08 million for the 44 centers, for an average annualized net savings of $199.21 per bed, but net costs/bed varied substantially among the facilities. We also analyzed the additional impact of the WWP. It may be economically cost-effective for management to play a more active role to prevent occupational morbidity, especially given the shortage of nursing personnel. Meaningful evaluation of OSH interventions requires advance planning to collect appropriate cost and effectiveness data.

Learning Objectives:
Describe how to build a business case for OSH such that one can evaluate and compare alternative intervention programs through an analysis of cost and effectiveness metrics.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: S. Lahiri , J. Gold , C.Levenstein “Estimation of Net-Costs for Prevention of Occupational Low Back Pain: Three Case Studies from the US, American Journal of Industrial Medicine, 48:530-541; 2005. S. Lahiri , J. Gold , C.Levenstein “Net-cost Model for Workplace Interventions” Journal of Safety Research, Volume 36 241-255. 2005. http://www.who.int/occupational_health/topics/lahiri.pdf 12. S. Lahiri , C. Levenstein , D. I. Nelson , B. J Rosenberg “The Cost Effectiveness of Occupational Health Interventions: Prevention of Silicosis”, American Journal of Industrial Medicine, 48:503-514; 2005. Economist: Sponsor NIH/ NIOSH, (2006-2010): Center for Excellence to Promote a Healthier Workforce. In charge of the Economic Analysis Team to develop and estimate economic models to assess effectiveness, costs, and benefits of interventions for work site health promotion in a collaborative study between- the University of Massachusetts –Lowell (UML), the University of Connecticut Health Center (UCHC), and the University of Connecticut (UCONN). Principal Investigator: (2003-2004). (Sponsor WHO)Cost Effectiveness Study on Occupational and Environmental Health WHO Task Force 14.Acted as project director and supervised the work in a joint project by three WHO Collaborating Centers in Occupational Health, University of Massachusetts at Lowell in the United States, TNO Work and Employment in The Netherlands, the National Institute of Occupational Health in India and an NGO the Institution of Public Health Engineers, India. Developed and estimated an economic model (UML Net-Cost Model)at the facility level that can estimate the net economic costs of workplace interventions by incorporating not only the costs of investment of equipment and labor, but also by taking into account the avoided costs of lost work time, medical care costs, and productivity improvements. External Collaborator (Consultant) WHO Choice Initiative Project. (2002). Evaluated the cost-effectiveness of specific interventions in two different studies for the prevention of occupationally induced i)back pain and ii) silicosis, using the simulation models based on the generalized cost effectiveness analysis (GCEA) developed by the WHO-Choice initiative for several of the WHO defined subregions of the world(WHO, 2002). Prepared Commissioned Background papers for the Box 5.5, pp130 in chapter 5, The World Health Report 2002, World Health Organization
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.