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

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.