Population, Sample, Setting and Years: Nursing worked hours for all nurses employed in Ontario hospitals and the average Relative Intensity Weight for each hospital who admitted patients between 1994 and 1998.

Design: A longitudinal design was employed.

Methods:A production function analysis was conducted to measure the changes in services delivered by acute care hospitals in Ontario between 1994-95 and 1998-99 and the hours of nursing service provided. The data was obtained from the Ontario Hospital Reporting System and the Canadian Institute of Health Information.

Findings: Inpatient episodes per nurse fell by almost 2 per cent. At the same time the number of beds was cut by over 20 per cent. As a result, the number of patients per bed increased by 12 per cent. Allowing for severity, there was a 20 per cent reduction in beds per episode and a 3.7 per cent reduction in nurses per episode.

The demands on nurses in acute care hospitals have increased as an increasing number of severity-adjusted episodes are served using fewer beds by fewer nurses. Human resource planning frameworks traditionally consider the effects of demographic change on the need for and supply of health care. Failure to recognize the variable and endogenous nature of other health care inputs in human resources planning leads to false impressions about the adequacy of existing supplies of human resources. Consideration of human resources in the context of the production function for health care services provides a meaningful way of improving the effectiveness and efficiency of human resources planning.

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Sigma Theta Tau International
July 22-24, 2004