A cost analysis of two academic-based nursing centers
Review TypeNone: Degree-based Submission
Repository Posting Date2020-08-28T16:46:31Z
Author DetailsDr. Deborah Vincent, RN, PhD, ANP
Lead Author Sigma AffliationBeta Mu
Level of EvidenceCase Study/Series
Research ApproachMixed/Multi Method Research
CINAHL HeadingsNurse-Managed Centers; Costs and Cost Analysis; Health Care Delivery; Nurse-Managed Centers--Economics
A nursing center is an ambulatory care clinic in which nurses provide health care to clients and manage the operational and financial functions of the center. During the 1980s, academic based nursing centers proliferated largely due to the need for clinical teaching sites for undergraduate and graduate nursing students and the availability of funding for demonstration projects for undeserved populations. However, financial instability has led to the closure of many nursing centers and placed others at risk for closure. Employing gross costing, activities based costing techniques, and time studies, this study analyzed the operating costs of a financially troubled academic-based nursing center and compared them to the operating costs of a financially thriving nursing center. Both nursing centers had similar visit times and direct labor costs but indirect labor costs were much higher at the financially troubled center. The ratio of direct costs to indirect costs was higher at the financially troubled center than at the financially stable center. Excess capacity was examined for both nursing centers and was greater at the financially troubled center. Scenario analyses were done to determine the number of patient visits needed to reach a break-even point for varying labor conditions. The financially troubled center must increase the number of patient visits and substantially decrease overhead in order to reach a break-even point. Understanding and managing operational costs are crucial for nursing center's to attain financial stability. The combined methodologies of gross-costing and activities-based costing to analyze operational costs enhanced understanding of the two nursing center's cost structures. Results of this study suggest that indirect labor costs play an important role in determining nursing center profitability. Nursing centers with lower ratios of indirect labor costs to direct labor are more likely to be profitable than are nursing centers with high ratios of indirect to direct labor costs. The findings of this study have practical implications for those schools of nursing contemplating starting a nursing center as well as those with existing nursing centers.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9910016; ProQuest document ID: 304434204. The author still retains copyright.
Degree GrantorUniversity of Michigan
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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