Examining the Value of Inpatient Nurse Staffing

An Assessment of Quality and Patient Care Costs

Dados Bibliográficos

ID9101684
AutoresGrant R Martsolf (0000-0003-1942-8683, RAND Corporation, autor correspondente), David Auerbach (0000-0003-1761-8993), David I Auerbach (0000-0003-2736-0586, RAND Corporation), Richele Benevent (Truven Health Analytics (United States)), Carol Stocks (0000-0003-3440-3193, Agency for Healthcare Research and Quality), H Joanna Jiang, Hui Jiang (0000-0001-8393-8368, Agency for Healthcare Research and Quality), Marjorie L Pearson (RAND Corporation), Emily D Ehrlich, Emily Ehrlich (Truven Health Analytics (United States)), Teresa B Gibson (0000-0002-5853-7447, Truven Health Analytics (United States))
Ano2014
Volume52
Fascículo11
Páginas982-988
Data de publicação2014-11-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000000248
PMID25304017
OpenAlexW2331689640
IdiomaEN
Citações recebidas2
Referências citadas21

BACKGROUND: Inpatient quality deficits have important implications for the health and well-being of patients. They also have important financial implications for payers and hospitals by leading to longer lengths of stay and higher intensity of treatment. Many of these costly quality deficits are particularly sensitive to nursing care. OBJECTIVE: To assess the effect of nurse staffing on quality of care and inpatient care costs. DESIGN: Longitudinal analysis using hospital nurse staffing data and the Healthcare Cost and Utilization Project State Inpatient Databases from 2008 through 2011. SUBJECTS: Hospital discharges from California, Nevada, and Maryland (n=18,474,860). METHODS: A longitudinal, hospital-fixed effect model was estimated to assess the effect of nurse staffing levels and skill mix on patient care costs, length of stay, and adverse events, adjusting for patient clinical and demographic characteristics. RESULTS: Increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, but did not lead to increases in patient care costs. Changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs. CONCLUSIONS: The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix can lead to improved quality and reduced length of stay at no additional cost

Acute care · Case mix index · Health care · Inpatient care · Longitudinal study · MEDLINE · Nursing care · Quality (philosophy) · Skill mix · Staffing · Emergency Medicine · Geriatric Care and Nursing Homes · Medicine · Nursing · Nursing education and management · Nursing Roles and Practices