Kristin L Reiter 1 , David W Harless , George H Pink , Barbara A Mark Show Affiliations »
Abstract
OBJECTIVE: To estimate the effect of minimum nurse staffing ratios on California acute care hospitals' financial performance. DATA SOURCES/STUDY SETTING: Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. STUDY DESIGN: The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1=lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. DATA COLLECTION/EXTRACTION METHODS: Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. PRINCIPAL FINDINGS: Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. CONCLUSIONS: Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. © Health Research and Educational Trust.
OBJECTIVE: To estimate the effect of minimum nurse staffing ratios on California acute care hospitals' financial performance. DATA SOURCES/STUDY SETTING: Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. STUDY DESIGN: The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1=lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. DATA COLLECTION/EXTRACTION METHODS: Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. PRINCIPAL FINDINGS: Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. CONCLUSIONS: Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. © Health Research and Educational Trust.
Entities: Chemical
Disease
Gene
Species
Mesh： See more »
Year: 2011
PMID： 22150627 PMCID： PMC3337946 DOI： 10.1111/j.1475-6773.2011.01356.x
Source DB: PubMed Journal: Health Serv Res ISSN： 0017-9124 Impact factor: 3.402