Research Objective: This research assesses the changes in levels and mix of hospital licensed nursing staff in the 1990s and the impact of these changes on the quality of patient care.
Study Design: Data are from the Pennsylvania Department of Health, the American Hospital Association, and the Pennsylvania Health Care Cost Containment Council. Staffing variables are yearly numbers of licensed nurses (RNs + LPNs), the ratio of licensed nurse/acuity adjusted patient days of care, and the skill mix of licensed nurse/nurse in acute-care Pennsylvania hospitals from 1991-1997. Patient care quality is measured through an aggregation of patient-based data to hospital-level rates of mortality, and hospital-acquired injuries, skin breakdown, infections and other complications. The confounding effects of patient acuity and hospital characteristics are measured through MediQual severity indexes and several hospital organizational variables. Licensed nurse staffing changes are analyzed with descriptive statistics. The relationship between licensed nurse staffing and patient care quality is analyzed with fixed effects regressions utilizing panel data.
Expected Findings: It is expected that levels of licensed nursing staff, the ratio of licensed nursing staff/patient and licensed/nurse have declined from 1991-1997, and that these lower ratios are associated with higher negative patient outcomes.
Implications for Policy, Delivery or Practice: Licensed nursing staff/patient and licensed nurses/nurses are important factors in the delivery of patient care. The quality implications of recent hospital efforts at cost-cutting through staff reductions should be further assessed. Staffing ratios may need to be federally or state mandated.
Learning Objectives: 1. Participants will describe the changes in licensed nurse staffing in Pennsylvania hospitals from 1991-7 2. Participants will assess the impact of licensed nurse/adjusted patient days of care and licensed nurse/nurse on adverse events in hospitals 3. Participants will discuss the implications of the findings for hospital administration and for legislation
Keywords: Health Care Restructuring, Quality of Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA