Abstract
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.
Sigma Membership
Beta Mu
Type
Dissertation
Format Type
Text-based Document
Study Design/Type
Case Study/Series
Research Approach
Mixed/Multi Method Research
Keywords:
Community Nursing, Healthcare Costs, Nurse Education
Advisors
Oakley, Deborah
Degree
PhD
Degree Grantor
University of Michigan
Degree Year
1998
Recommended Citation
Vincent, Deborah, "A cost analysis of two academic-based nursing centers" (2020). Dissertations. 1420.
https://www.sigmarepository.org/dissertations/1420
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
None: Degree-based Submission
Acquisition
Proxy-submission
Date of Issue
2020-08-28
Full Text of Presentation
wf_yes
Description
This 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.