Beyond demographic change in human resources planning: an extended framework and application to nursing

摘要

Objectives: To introduce health care production functions into human resources planning and to apply thenapproach to analysing the need for registered nurses in Ontario during a period of major reduction in inpatientncapacity.nMethods: Measurement of changes in services delivered by acute care hospitals in Ontario between 1994/95 andn1998/99, and comparison with changes in the mix of human resources, non-human resources and patient needs.nResults: Inpatient episodes per nurse fell by almost 2%. At the same time the number of beds was cut by over 20%.nAs a result, the number of patients per bed increased by 12%. Allowing for severity, there was a 20% reduction innbeds per episode and a 3.7% reduction in nurses per episode.nConclusions: The demands on nurses in acute care hospitals have increased as an increasing number of severityadjustednepisodes are served using fewer beds by a reduced number of nurses. Human resources planningntraditionally only considers the effects of demographic change on the need for and supply of health care. Failure tonrecognize the variable and endogenous nature of other health care inputs leads to false impressions about thenadequacy of existing supplies of human resources. Consideration of human resources in the context of thenproduction function for health services provides a meaningful way of improving the effectiveness and ef. ciency ofnhuman resources planning.