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Nurse staffing patterns and hospital efficiency in the United States

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  • Bloom, Joan R.
  • Alexander, Jeffrey A.
  • Nuchols, Beverly A.

Abstract

The objective of this exploratory study was to assess the effects of four nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; part-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were specified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the models to control for the effect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. These findings provide partial support of the theory. Implications of our findings for future research on hospital management are discussed.

Suggested Citation

  • Bloom, Joan R. & Alexander, Jeffrey A. & Nuchols, Beverly A., 1997. "Nurse staffing patterns and hospital efficiency in the United States," Social Science & Medicine, Elsevier, vol. 44(2), pages 147-155, January.
    • Handle: RePEc:eee:socmed:v:44:y:1997:i:2:p:147-155
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    Cited by:

    1. Sebastiano, Antonio & Belvedere, Valeria & Grando, Alberto & Giangreco, Antonio, 2017. "The effect of capacity management strategies on employees' well-being: A quantitative investigation into the long-term healthcare industry," European Management Journal, Elsevier, vol. 35(4), pages 563-573.
    2. Sunil K. Dixit & Murali Sambasivan, 2020. "An Integrated Multitheoretical Perspective of Public Healthcare Services Delivery Organizations," Public Organization Review, Springer, vol. 20(2), pages 319-335, June.
    3. Carina Fagefors & Björn Lantz, 2021. "Application of Portfolio Theory to Healthcare Capacity Management," IJERPH, MDPI, vol. 18(2), pages 1-9, January.
    4. Benson, Alan, 2013. "Firm-sponsored general education and mobility frictions: Evidence from hospital sponsorship of nursing schools and faculty," Journal of Health Economics, Elsevier, vol. 32(1), pages 149-159.
    5. Carina Fagefors & Björn Lantz & Peter Rosén, 2020. "Creating Short-Term Volume Flexibility in Healthcare Capacity Management," IJERPH, MDPI, vol. 17(22), pages 1-18, November.
    6. Gold, Heather T. & McDermott, Cara & Hoomans, Ties & Wagner, Todd H., 2022. "Cost data in implementation science: categories and approaches to costing," LSE Research Online Documents on Economics 113704, London School of Economics and Political Science, LSE Library.

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