Paper
Friday, July 23, 2004
This presentation is part of : Health Human Resource Planning
An Examination of Relationships among Nursing Services Utilization, an Estimate of Population Health and Overall Health Status Outcomes
Linda O'Brien-Pallas, RN, PhD, Faculty of Nursing, Faculty of Nursing, University of Toronto, Toronto, ON, Canada

Objective: The study examined 1) whether population health needs explain variation in self-report of overnight hospital services (as a proxy for self-report use of nursing services) and in nursing utilization, and 2) whether nursing utilization explains variations in hospital-level outcomes.

Sample: The sample includes individuals living in Ontario, Canada and who were randomly selected to participate in 1996 and 2001 health surveys.

Methods: The unit of analysis is acute care hospitals in Ontario, Canada and the population age 20 and over which they serve. The research team developed a method of defining hospital catchment areas that allows for overlapping service areas, and gives greater weight to populations that make greater use of the facility. Moreover, this method facilitates the measurement of “need” indicators for the catchment populations.

Findings: Catchment area populations with higher proportions of chronic conditions and disabilities have higher proportions of overnight patient hospital stays compared to catchment areas with lower proportions of chronic conditions and disabilities.

Nursing hours per patient day has a significant negative effect on length of stay. In other words, the more nursing hours worked on a daily basis in a hospital, the shorter the average length of patient stay in that hospital.

Conclusions: While populations with higher proportions of chronic health conditions and disabilities will stay overnight in hospitals longer, variations in nurse supply may be affecting the ability of hospitals to provide the appropriate level of care for the populations they serve. More nursing hours per day leads to shorter lengths of stay.

Implications: Decision makers should take into account that although it may increase costs to have more nursing hours, costs may be decreased by the lower average length of patient stay and potential increased throughput. Increased throughput may lead to increased access to hospital services and decreased wait time.

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