Nurse staffing and hospital ownership in California.
OBJECTIVE
The purpose of this study is to describe the relationship between nurse staffing and owner type or specific corporate owner in California acute care hospitals.


BACKGROUND
Little empirical data exist regarding nurse staffing as it relates to owner type or specific corporate owner. With minimum staffing ratios scheduled to be implemented in January 2004, this study provides baseline data for evaluating the impact of minimum staffing ratios in California.


METHODS
The study design is descriptive and cross-sectional. Data used in this study are for short-term general hospitals that reported to the California Office of Statewide Health Planning and Development database for fiscal years ending in 1997 through 1999. Six regression models were estimated using pooled data from the 3 years of data.


RESULTS
The most consistent significant findings are: increased patient days or patient discharges predict increased registered nurse (RN) hours; lower RN wages predict increased RN hours; higher technology scores predict increased RN hours; and in 1998 there was an across-the-board decrease in RN hours. Other significant findings include that for-profit hospitals and for-profit systems had fewer RN productive hours for medical-surgical nursing, and select corporate owners, unrelated to profit status, had consistently fewer RN productive hours for medical-surgical nursing.


CONCLUSIONS
For-profit hospitals and systems behaved differently in the healthcare market environment of the late 1990s. Select nonprofit systems were also using significantly less RN staffing. Other findings support the implication that as technology sophistication increases, there will be a need for increased RN hours to manage the advanced technology. This runs counter to the argument that increasing technology will decrease the need for RN hours. Finally, as discharges go up, the need for RN hours increases.
Seago
Jean Ann
JA
Department of Community Health Systems, School of Nursing, University of California-San Francisco, 2 Koret Way, San Francisco, CA 94143-0608, USA. Jean.ann.seago@nursing.ucsf.edu
Spetz
Joanne
J
Mitchell
Shannon
S
D002140:California; D003430:Cross-Sectional Studies; D017598:Efficiency, Organizational; D006767:Hospitals, District / Q000458:organization & administration; D006769:Hospitals, General / Q000458:organization & administration*; D006777:Hospitals, Proprietary / Q000458:organization & administration; D006779:Hospitals, Public / Q000458:organization & administration; D016519:Hospitals, Religious / Q000458:organization & administration; D006788:Hospitals, Voluntary / Q000458:organization & administration; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D015401:Nursing Administration Research; D009741:Nursing Staff, Hospital / Q000191:economics / Q000600:supply & distribution*; D010067:Ownership / Q000458:organization & administration*; D010351:Patient Discharge / Q000706:statistics & numerical data; D020415:Personnel Downsizing; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011237:Predictive Value of Tests; D019984:Quality Indicators, Health Care; D012044:Regression Analysis; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D016526:Workload