title: Nurse staffing in hospitals: is there a business case for quality?
abstract: We construct national estimates of the cost of increasing hospital nurse staffing and associated reductions in days, deaths, and adverse outcomes. Raising the proportion of nursing hours provided by registered nurses (RNs) without increasing total nursing hours is associated with a net reduction in costs. Increasing nursing hours, with or without increasing the proportion of hours provided by RNs, reduces days, adverse outcomes, and patient deaths, but with a net increase in hospital costs of 1.5 percent or less at the staffing levels modeled. Whether or not staffing should be increased depends on the value patients and payers assign to avoided deaths and complications.
authors.affiliation: Department of Health Services, School of Public Health, University of California, Los Angeles, CA, USA. needlema@ucla.edu
authors.forename: Jack
authors.initials: J
authors.lastname: Needleman
authors.forename: Peter I
authors.initials: PI
authors.lastname: Buerhaus
authors.forename: Maureen
authors.initials: M
authors.lastname: Stewart
authors.forename: Katya
authors.initials: K
authors.lastname: Zelevinsky
authors.forename: Soeren
authors.initials: S
authors.lastname: Mattke
mesh_terms: D003363:Cost Control; D004469:Economics, Hospital; D006769:Hospitals, General; D006801:Humans; D009741:Nursing Staff, Hospital / Q000191:economics / Q000458:organization & administration / Q000600:supply & distribution*; D011787:Quality of Health Care; D014481:United States