Impact of Hospital Nurse Staffing on the Quality of Patient Care. Abstract,Executive Summary and Dissertation

摘要

Reduced and capitated reimbursements from government agencies, insurancecompanies, and HMOs have pressured hospitals to minimize costs and price compete. Hospitals have cut costs and raised productivity through staff reductions, replacement of costlier licensed staff with cheaper unlicensed staff, cross-training, and intensive utilization of the workforce. The study uses data from the universe of general, acute-care Pennsyvania hospitals from 1991 to 1997 to examine the changes in nursing staff and the impact of nursing staff/patient load and skill mix on the rates of adverese events among all patients. It describes the percent change in several categories of nursing staff and analyzes the relationship between nurse staffing and several adverse events with fixed effects multivariate regressions which control for other hospital and patient characteristics, including patient severity.