Health Affairs

Health Affairs, 25, no. 1 (2006): 204-211 doi: 10.1377/hlthaff.25.1.204 © 2006 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Nurse Staffing In Hospitals: Is There A Business Case For Quality?

Jack Needleman, Peter I. Buerhaus, Maureen Stewart, Katya Zelevinsky and Soeren Mattke

We construct national estimates of the cost of increasing hospital nurse staffing and associated reductions in days, deaths, and adverse outcomes. Raising the proportion of nursing hours provided by registered nurses (RNs) without increasing total nursing hours is associated with a net reduction in costs. Increasing nursing hours, with or without increasing the proportion of hours provided by RNs, reduces days, adverse outcomes, and patient deaths, but with a net increase in hospital costs of 1.5 percent or less at the staffing levels modeled. Whether or not staffing should be increased depends on the value patients and payers assign to avoided deaths and complications.

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