Are There Economic Benefits from Increased Nursing Staffing in Acute Hospitals?

Twigg, Diane E.

Friday, 26 July 2013: 10:55 AM

Diane E. Twigg, PhD, MBA, BHlthSc (Nsg) (Hons), RN, RM
School of Nursing and Midwifery, Edith Cowan University, Edith Cowan University, Joondalup, Australia
Christine Duffield, RN, PhD
Centre for Health Services Management, University of Technology, Sydney, Sydney, Australia

Learning Objective 1: discuss the economic impact of increased nursing hours of care on health outcomes

Learning Objective 2: discuss evidence in regard increased nursing hours of care, improved health outcomes and cost-effectiveness

Purpose: Increased availability of treatment interventions and changing technology has increased demand for health care while the global financial crisis has increased calls for cost reduction. The pressure on nurse leaders to reduce staffing costs is significant. This research assessed the economic impact of increased nurse staffing on health outcomes in adult teaching hospitals in Perth, Western Australia. It provides evidence that is relevant to policy development.

Methods: This longitudinal study involved the retrospective analysis of a cohort of multi-day stay patients admitted to adult teaching hospitals. Hospital morbidity and staffing data were used to analyse nursing-sensitive outcomes pre and post implementation of improved nurse staffing. Data comprised 22 months prior to implementation of the improved staffing (pre-implementation), 6 months transition and 22 months following implementation of the improved staffing (post-implementation). Increased nurse staffing following implementation of the staffing method constituted the cost of the intervention.

Results: The number of nursing-sensitive outcomes was 1,357 less than expected post implementation and included 155 fewer ‘failure to rescue’ events. The 1,202 other nursing-sensitive outcomes were also prevented and one outcome showed an increase of 493. Life years gained (based on the failure to rescue events prevented) was 1,088. The cost per life year gained was AUD$8,907.

Conclusion: Improvements in nurse staffing method were cost-effective when compared with interventions thresholds used in Australia. Furthermore, these results meet cost-effectiveness thresholds of the United States of America, the United Kingdom and Sweden suggesting broader application that that of Australia. These results are supportive of similar findings in the literature and suggest increasing nurse staffing is a cost-effective strategy. Nurse leaders may utilise these findings to influence policy development and reduce demands for staffing reductions.

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