title: Hospital registered nurse shortages: environmental, patient, and institutional predictors.
abstract: OBJECTIVE
  To examine the characteristics of acute-care hospitals that report registered nurse shortages when a widespread shortage exists and when a widespread shortage is no longer evident.
  
  
  METHODS
  Secondary data from the American Hospital Association's Nursing Personnel Survey from 1990 and 1992 were used. The study population was all acute-care hospitals in the United States.
  
  
  METHODS
  Outcome variables included whether a hospital experienced a shortage in 1990, when many hospitals reported a nursing shortage, or whether a hospital reported a shortage in both 1990 and 1992. Predictor variables included environmental, patient, and institutional characteristics. Associations between predictor and outcome variables were investigated using probit analyses.
  
  
  RESULTS
  Location in the South, a high percentage of nonwhite county residents, a high percentage of patients with Medicaid or Medicare as payer, a higher patient acuity, and use of team or functional nursing care delivery consistently predicted hospitals reporting shortages both when there was a widespread shortage and when there was no widespread shortage.
  
  
  CONCLUSIONS
  Although some characteristics under the direct control of hospitals, such as nursing care delivery model, are associated with their reporting a shortage of nurses, shortage is also strongly associated with broader population characteristics such as minority communities and a public insurance payer mix. Awareness of these broader factors may help inform policies to improve the distribution of nurse supply.
authors.affiliation: Department of Community Health Systems, University of California, San Francisco 94143-0608, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Seago
authors.forename: M
authors.initials: M
authors.lastname: Ash
authors.forename: J
authors.initials: J
authors.lastname: Spetz
authors.forename: J
authors.initials: J
authors.lastname: Coffman
authors.forename: K
authors.initials: K
authors.lastname: Grumbach
mesh_terms: D000368:Aged; D000573:American Hospital Association; D003625:Data Collection; D006302:Health Services Research; D006742:Hospital Bed Capacity; D006761:Hospitals / Q000145:classification* / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D009746:Nursing, Team; D017063:Outcome Assessment, Health Care; D010067:Ownership; D010361:Patients / Q000145:classification; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D012456:Salaries and Fringe Benefits; D012959:Socioeconomic Factors; D014481:United States; D000078329:Workforce