The analyses show that costs and outcomes of intermediate
care are partly explained by differences in
patient and service characteristics, however, the impact
of service skill mix is limited (Table 2). There is weak
evidence (p = 0.090) that the ratio of support staff to
qualified staff impact on health gains (measured by the
change in EQ-5D) seen during care, with higher proportions
of support staff being associated with greater
improvement. There is stronger evidence (p = 0.011)
that higher numbers of different types of staff are associated
with lower costs.
There are several possible explanations for the greater
improvements in EQ-5D in patients when who utilise
more support staff (SS) relative to qualified staff (QS).
Qualitative feedback from the same study suggests that
support staff spend more time with patients than qualified
staff, and perform more of the ‘hands on’ work,
which may lead to better improvements in outcome.