Artikel
The impact of nurse staffing levels on nursing-sensitive patient outcomes: a multilevel regression approach
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.
- Language
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Englisch
- Bibliographic citation
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Journal: The European Journal of Health Economics ; ISSN: 1618-7601 ; Volume: 22 ; Year: 2021 ; Issue: 5 ; Pages: 833-846 ; Berlin, Heidelberg: Springer
- Classification
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Medizin, Gesundheit
Demographic Trends, Macroeconomic Effects, and Forecasts
- Subject
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Nurse staffing
Nursing-sensitive patient outcomes
Quality of care
Acute care
Multilevel models
- Event
-
Geistige Schöpfung
- (who)
-
Dietermann, Karina
Winter, Vera
Schneider, Udo
Schreyögg, Jonas
- Event
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Veröffentlichung
- (who)
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Springer
- (where)
-
Berlin, Heidelberg
- (when)
-
2021
- DOI
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doi:10.1007/s10198-021-01292-2
- Last update
-
10.03.2025, 11:41 AM CET
Data provider
ZBW - Deutsche Zentralbibliothek für Wirtschaftswissenschaften - Leibniz-Informationszentrum Wirtschaft. If you have any questions about the object, please contact the data provider.
Object type
- Artikel
Associated
- Dietermann, Karina
- Winter, Vera
- Schneider, Udo
- Schreyögg, Jonas
- Springer
Time of origin
- 2021
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Assessment of staffing needs for registered nurses and licensed practical nurses at primary care units in Brazil using Workload Indicators of Staffing Need (WISN) method
The impact of nurse staffing levels on nursing-sensitive patient outcomes: a multilevel regression approach
Nurse staffing, direct nursing care hours and patient mortality in Taiwan: the longitudinal analysis of hospital nurse staffing and patient outcome study
Cost-effectiveness of recommended nurse staffing levels for short-stay skilled nursing facility patients
Missed nursing care, non-nursing tasks, staffing adequacy, and job satisfaction among nurses in a teaching hospital in Egypt
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Exploring factors that affect nurse staffing: a descriptive qualitative study from nurse managers’ perspective
Decision support for team staffing : a probabilistic approach for multilevel fit