Cost-effectiveness of a physician-nurse supplementary triage assessment team at an academic tertiary care XXXX .

@entity1 @entity341
OBJECTIVE: The purpose of this study was to evaluate the cost-effectiveness of physician-nurse supplementary triage assistance team (MDRNSTAT) from a hospital and @entity1 perspective. METHODS: This was a cost-effectiveness evaluation of a cluster randomized control trial comparing the MDRNSTAT with nurse-only triage in the @entity341 ( @entity341 ) between the hours of 0800 and 1500. Cost was MDRNSTAT salary. Revenue was from Ontario's Pay-for-Results and @entity1 volume-case mix payment programs. The incremental cost-effectiveness ratio was based on MDRNSTAT cost and three consequence assessments: 1) per additional @entity1 -seen; 2) per physician initial assessment (PIA) hour saved; and 3) per @entity341 length of stay (EDLOS) hour saved. @entity1 opportunity cost was determined. @entity1 satisfaction was quantified by a cost-benefit ratio. A sensitivity analysis extrapolating MDRNSTAT to different working hours, salary, and willingness-to-pay data was performed. RESULTS: The added cost of the MDRNSTAT was  3,597.27 [ 1,729.47 to    ] per additional @entity1 -seen,  75.37 [ 67.99 to  105.30] per PIA hour saved, and  112.99 [ 74.68 to  251.43] per EDLOS hour saved. From the hospital perspective, the cost-benefit ratio was 38.6 [19.0 to    ] and net present value of - 447,996 [- 435,646 to - 459,900]. For @entity1 , the cost-benefit ratio for satisfaction was 2.8 [2.3 to 4.6]. If MDRNSTAT performance were consistently implemented from noon to midnight, it would be more cost-effective. CONCLUSIONS: The MDRNSTAT is not a cost-effective daytime strategy but appears to be more feasible during time periods with higher @entity1 volume, such as late morning to evening.
