Nurse Staffing in Hospitals

Is There a Business Case for Quality?

Published in: Health Affairs, v. 25, no. 1, Jan./Feb. 2006, p. 204-211

Posted on RAND.org on January 01, 2006

by Jack Needleman, Peter Buerhaus, Maureen Stewart, Katya Zelevinsky, Soeren Mattke

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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.

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