RES E A R C H Open Access
Effects of a mobility monitoring system on
the cost of care in relation to
reimbursement at Swiss nursing homes:
learnings from a randomized controlled
, Rigo Tietz
, Heidrun Gattinger
, Virpi Hantikainen
and Stefan Ott
Background/objective: Nursing homes in Switzerland are under pressure to efficiently coordinate staff activities to
cover their personnel costs under the care financing system. In this study, the use of a mobility monitoring system
accompanied with case conferences was investigated in order to improve sleep quality and estimate the cost
benefit of this intervention.
Method: In an open two-phase randomized controlled trial at three nursing homes, residents with cognitive
impairment were randomly assigned to an intervention group and a control group. In the intervention group,
a 10-week period of intensive use of the monitoring system and case conferences led by an advanced nurse
practitioner (Phase I) was followed by 3 months of reduced use of the monitoring system and case conferences led by
an internal registered nurse (Phase II). In the control group, the monitoring system was only used for data acquisition.
Nurses reported the activities with a specifically developed tool. Based on the recorded activities, the cost of care was
calculated. The correlating reimbursement per patient was calculated from the care levels in the Swiss reimbursement
system. Data from 44 residents was included in the analysis with a linear mixed model.
Results: Although analysis revealed no statistically significant effects, results indicate that the use of a monitoring system
can guide nurses in organizing their tasks to increase effectiveness. Information systems such as the mobility monitor can
help to identify single outliers that do not correspond with the overall situation.
Conclusion: In the health care system, problematic individual cases can account for a disproportionally high cost levels. It
was shown that information systems can have a significant economic impact in the long run.
Trial registration: The study is registered at the German Clinical Trials Register under the Nr. DRKS-ID: DRKS00006829.
Keywords: Health economics, Cost of care, Reimbursement, Monitoring system, Nursing home
* Correspondence: email@example.com
Institute of Business Management, University of Applied Sciences St. Gallen,
Rosenbergstrasse 59, Postfach, 9001 St. Gallen, Switzerland
Full list of author information is available at the end of the article
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license, and indicate if changes were made.
Stark et al. Health Economics Review (2017) 7:43