ArticleJournal of general internal medicine2021
Evaluating the Costs and Outcomes of Hospital Nursing Resources: a Matched Cohort Study of Patients with Common Medical Conditions.
Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
26 citing papers in PubMed.
- Safe Minimum Nurse Staffing Requirements for Hospitals: Evidence From Pennsylvania.Medical care · 2026Observational
- Strategies to Position the Clinical Academic Nurse in University, Teaching and General Hospitals.Journal of advanced nursing · 2026Article
- The illusion of improved nurse staffing levels in South Korea during COVID-19: a statistical artifact of policy changes and declining patient volume.BMC nursing · 2026Article
- Association of Emergency Department and Medical-Surgical Nurse Staffing on Patient Departures Against Medical Advice.Journal of emergency nursing · 2026Article
- Poor Patient Care Outcomes and Nurse Job Outcomes Associated With Unfavorable Intensive Care Unit and Emergency Department Nurse Work Environments: Implications for Critical Care Medicine.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2025Article
- Skill mix versus flexibility: Decoding nurse staffing impacts on critical access hospitals.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2025Article
- Workload and short sickness absences in a cohort of Finnish hospital employees.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Association between NUTRIC score and ICU mortality in patients with sepsis: a prospective cohort study.Frontiers in nutrition · 2025Article
- Hospital nurse staffing variation and Covid-19 deaths: A cross-sectional study.International journal of nursing studies · 2024Article
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- Emergent Penile Venous Stripping for Treating Adolescent Impotence.Life (Basel, Switzerland) · 2024Article
- A Review of Disparities in Outcomes of Hospitalized Patients with Limited English Proficiency: The Importance of Nursing Resources.Journal of health care for the poor and underserved · 2024Review
- 'Thank goodness you're here'. Exploring the impact on patients, family carers and staff of enhanced 7-day specialist palliative care services: A mixed methods study.Palliative medicine · 2023Article
- The Relationship Between Scope of Practice Laws for Task Delegation and Nurse Turnover in Home Health.Journal of the American Medical Directors Association · 2023Article
- Application of the 6S management strategies.Nursing open · 2023Article
- Cost comparisons and factors related to cost per stay in intensive care units in Belgium.BMC health services research · 2023Article
- Patient Outcomes and Hospital Nurses' Workload: A Cross-Sectional Observational Study in Slovenian Hospitals Using the RN4CAST Survey.Zdravstveno varstvo · 2023Article
- Explaining racial disparities in surgical survival: a tapered match analysis of patient and hospital factors.BMJ open · 2023Article
- Defining Multimorbidity in Older Patients Hospitalized with Medical Conditions.Journal of general internal medicine · 2023Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundNursing resources, such as staffing ratios and skill mix, vary across hospitals. Better nursing resources have been linked to better patient outcomes but are assumed to increase costs. The value of investments in nursing resources, in terms of clinical benefits relative to costs, is unclear.
objectiveTo determine whether there are differential clinical outcomes, costs, and value among medical patients at hospitals characterized by better or worse nursing resources.
designMatched cohort study of patients in 306 acute care hospitals. PATIENTS: A total of 74,045 matched pairs of fee-for-service Medicare beneficiaries admitted for common medical conditions (25,446 sepsis pairs; 16,332 congestive heart failure pairs; 12,811 pneumonia pairs; 10,598 stroke pairs; 8858 acute myocardial infarction pairs). Patients were also matched on hospital size, technology, and teaching status. MAIN MEASURES: Better (n = 76) and worse (n = 230) nursing resourced hospitals were defined by patient-to-nurse ratios, skill mix, proportions of bachelors-degree nurses, and nurse work environments. Outcomes included 30-day mortality, readmission, and resource utilization-based costs. KEY
resultsPatients in hospitals with better nursing resources had significantly lower 30-day mortality (16.1% vs 17.1%, p < 0.0001) and fewer readmissions (32.3% vs 33.6%, p < 0.0001) yet costs were not significantly different ($18,848 vs 18,671, p = 0.133). The greatest outcomes and cost advantage of better nursing resourced hospitals were in patients with sepsis who had lower mortality (25.3% vs 27.6%, p < 0.0001). Overall, patients with the highest risk of mortality on admission experienced the greatest reductions in mortality and readmission from better nursing at no difference in cost.
conclusionsMedicare beneficiaries with common medical conditions admitted to hospitals with better nursing resources experienced more favorable outcomes at almost no difference in cost.
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