ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2021
The impact of nurse staffing levels on nursing-sensitive patient outcomes: a multilevel regression approach.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 13 citations in OpenAlex.
- Organisational interventions in nursing care: A scoping review and descriptive system to support comparison.International journal of nursing studies advances · 2026Article
- Does moral distress in emergency department nurses contribute to intentions to leave their post, specialisation, or profession: A systematic review.International journal of nursing studies advances · 2024Review
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- Staffing levels and hospital mortality in England: a national panel study using routinely collected data.BMJ open · 2023Observational
- Article
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Authors and funding
4 authors at 3 institutions in 1 country.
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Abstract
The goal of this study is to provide empirical evidence of the impact of nurse staffing levels on seven nursing-sensitive patient outcomes (NSPOs) at the hospital unit level. Combining a very large set of claims data from a German health insurer with mandatory quality reports published by every hospital in Germany, our data set comprises approximately 3.2 million hospital stays in more than 900 hospitals over a period of 5 years. Accounting for the grouping structure of our data (i.e., patients grouped in unit types), we estimate cross-sectional, two-level generalized linear mixed models (GLMMs) with inpatient cases at level 1 and units types (e.g., internal medicine, geriatrics) at level 2. Our regressions yield 32 significant results in the expected direction. We find that differentiating between unit types using a multilevel regression approach and including postdischarge NSPOs adds important insights to our understanding of the relationship between nurse staffing levels and NSPOs. Extending our main model by categorizing inpatient cases according to their clinical complexity, we are able to rule out hidden effects beyond the level of unit types.
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