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Infections, accidents and nursing overtime in a neonatal intensive care unit

Author

Listed:
  • Marc Beltempo

    (McGill University Health Centre)

  • Georges Bresson

    (Université Paris II)

  • Jean-Michel Étienne

    (Université Paris-Sud)

  • Guy Lacroix

    (Université Laval)

Abstract

The paper investigates the effects of nursing overtime on nosocomial infections and medical accidents in a neonatal intensive care unit (NICU). The literature lacks clear evidence on this issue and we conjecture that this may be due to empirical and methodological factors. We model the occurrences of both events using a sample of 3979 neonates who represents over 84,846 observations (infant/days). We exploit an important change in workforce arrangement that was implemented in June 2012, and which aimed at reducing overtime hours to identify a causal impact between the latter and the two outcomes of interest. We contrast the results using a standard mixed-effects logit model with those of a semiparametric mixed-effects logit model. Contrary to the mixed-effects logit model, the semiparametric model unequivocally shows that both adverse events are impacted by nursing overtime as well as being highly sensitive to infant and NICU-related characteristics. Furthermore, the mixed-effects logit model is rejected in favour of the semiparametric one.

Suggested Citation

  • Marc Beltempo & Georges Bresson & Jean-Michel Étienne & Guy Lacroix, 2022. "Infections, accidents and nursing overtime in a neonatal intensive care unit," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 627-643, June.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:4:d:10.1007_s10198-021-01386-x
    DOI: 10.1007/s10198-021-01386-x
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    References listed on IDEAS

    as
    1. Beltempo, Marc & Bresson, Georges & Lacroix, Guy, 2020. "Using Machine Learning to Predict Nosocomial Infections and Medical Accidents in a NICU," IZA Discussion Papers 13099, Institute of Labor Economics (IZA).
    2. Sandra E. Black & Paul J. Devereux & Kjell G. Salvanes, 2007. "From the Cradle to the Labor Market? The Effect of Birth Weight on Adult Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 409-439.
    3. Prashant Bharadwaj & Petter Lundborg & Dan-Olof Rooth, 2018. "Birth Weight in the Long Run," Journal of Human Resources, University of Wisconsin Press, vol. 53(1), pages 189-231.
    4. Cook, Andrew & Gaynor, Martin & Stephens Jr, Melvin & Taylor, Lowell, 2012. "The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation," Journal of Health Economics, Elsevier, vol. 31(2), pages 340-348.
    5. David Figlio & Jonathan Guryan & Krzysztof Karbownik & Jeffrey Roth, 2014. "The Effects of Poor Neonatal Health on Children's Cognitive Development," American Economic Review, American Economic Association, vol. 104(12), pages 3921-3955, December.
    6. Seth Freedman, 2016. "Capacity and Utilization in Health Care: The Effect of Empty Beds on Neonatal Intensive Care Admission," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 154-185, May.
    7. repec:ucn:wpaper:10197/317 is not listed on IDEAS
    8. Rubén E. Mújica‐Mota & Paolo Landa & Martin Pitt & Mike Allen & Anne Spencer, 2020. "The heterogeneous causal effects of neonatal care: a model of endogenous demand for multiple treatment options based on geographical access to care," Health Economics, John Wiley & Sons, Ltd., vol. 29(1), pages 46-60, January.
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    More about this item

    Keywords

    Neonatal health outcomes; Nursing overtime; Parametric and semiparametric mixed-effects logit models;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • C18 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Methodolical Issues: General

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