Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals
Objective To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance. Data Sources/Study Setting Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Heal...
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| Veröffentlicht in: | Health services research 2012-06, Vol.47 (3pt1), p.1030-1050 |
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| creator | Reiter, Kristin L. Harless, David W. Pink, George H. Mark, Barbara A. |
| description | Objective
To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance.
Data Sources/Study Setting
Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states.
Study Design
The study employs a difference‐in‐difference analytical approach. Hospitals are grouped into quartiles based on pre‐regulation nurse staffing levels in adult medical‐surgical and pediatric units (quartile 1 = lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period.
Data Collection/Extraction Methods
Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD.
Principal Findings
Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3.
Conclusions
Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. |
| doi_str_mv | 10.1111/j.1475-6773.2011.01356.x |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3337946</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A296160043</galeid><sourcerecordid>A296160043</sourcerecordid><originalsourceid>FETCH-LOGICAL-g7156-8c2f376522f9ec9ac127819d5062d397c9fb3429ecb9bce93d008735021d7c483</originalsourceid><addsrcrecordid>eNqNk22L1DAQx4so3nr6FSQgiIKteWib5o1wLHe3wnonnqL4JmTTtJs1Tdam1b1vb-qtu1tZxBaaJvObYf6ZmSgCCCYoPK9XCUppFueUkgRDhBKISJYnm3vRZGe4H00gRDRmCKcn0SPvVxDCghTpw-gEY5TBHNNJ9OWdtrrpG3DVt16Bm05UlbY1mKtaeyM67SwQtgTdUoELbYWVWhjwXrWVa5uwU8BVYCqMDnurBZg5v9adMP5x9KAKi3qyXU-jTxfnH6ezeH59-XZ6No9rirI8LiSuCM0zjCumJBMSYVogVg7plYRRyaoFSXGwLdhCKkbKIIKSDGJUUpkW5DR6cxd33S8aVUplu1YYvm51I9pb7oTmY4vVS167H5wQQlmahwAvtgFa971XvuON9lIZI6xyvecIYgJZjvH_oAhjyFKEAvrsL3Tl-taGmxgolGZZztieqoVRXNvKhRTlEJSfYZajHMKUBCo-QtXKqqDHWVXpcDzikyN8eEvVaHnU4eXIITCd2nS16L3nxeX8X8lsWemMUbXiobbT6zH__IBfKmG6pXemHzrLj8FXB-Ci99oqHz5e18vO3-Uywp8e1n1X8D-tvW-Mn0Ht7c6OIB9GiK_4MCl8mBQ-jBD_PUJ8w2fnNx-G371S7YPCXQDRfgteJPh-vrrkXyGZsYIGd_ILmhgXrw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1011455699</pqid></control><display><type>article</type><title>Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Reiter, Kristin L. ; Harless, David W. ; Pink, George H. ; Mark, Barbara A.</creator><creatorcontrib>Reiter, Kristin L. ; Harless, David W. ; Pink, George H. ; Mark, Barbara A.</creatorcontrib><description>Objective
To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance.
Data Sources/Study Setting
Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states.
Study Design
The study employs a difference‐in‐difference analytical approach. Hospitals are grouped into quartiles based on pre‐regulation nurse staffing levels in adult medical‐surgical and pediatric units (quartile 1 = lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period.
Data Collection/Extraction Methods
Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD.
Principal Findings
Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3.
Conclusions
Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals.</description><identifier>ISSN: 0017-9124</identifier><identifier>EISSN: 1475-6773</identifier><identifier>DOI: 10.1111/j.1475-6773.2011.01356.x</identifier><identifier>PMID: 22150627</identifier><identifier>CODEN: HESEA5</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>AB394 ; Acute services ; Adult ; California ; Child ; Economics, Hospital ; Financial performance ; Health care costs ; Health planning ; Hospital Costs ; Hospitals ; Hospitals, General - economics ; Humans ; Legislation ; Legislation, Hospital - economics ; Medical care, Cost of ; Medicare ; Models, Econometric ; Nurse staffing ratios ; Nurses ; Nursing services ; Nursing Staff, Hospital - economics ; Nursing Staff, Hospital - supply & distribution ; Original ; Personnel Staffing and Scheduling - economics ; Personnel Staffing and Scheduling - legislation & jurisprudence ; Ratios ; Regression Analysis ; Staffing ; Studies ; Surveys ; Workforce ; Workforce planning</subject><ispartof>Health services research, 2012-06, Vol.47 (3pt1), p.1030-1050</ispartof><rights>Health Research and Educational Trust</rights><rights>Health Research and Educational Trust.</rights><rights>COPYRIGHT 2012 Health Research and Educational Trust</rights><rights>COPYRIGHT 2012 Health Research and Educational Trust</rights><rights>2012 Health Research and Educational Trust</rights><rights>Health Research and Educational Trust 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337946/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337946/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,27901,27902,30976,30977,45550,45551,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22150627$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Reiter, Kristin L.</creatorcontrib><creatorcontrib>Harless, David W.</creatorcontrib><creatorcontrib>Pink, George H.</creatorcontrib><creatorcontrib>Mark, Barbara A.</creatorcontrib><title>Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals</title><title>Health services research</title><addtitle>Health Serv Res</addtitle><description>Objective
To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance.
Data Sources/Study Setting
Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states.
Study Design
The study employs a difference‐in‐difference analytical approach. Hospitals are grouped into quartiles based on pre‐regulation nurse staffing levels in adult medical‐surgical and pediatric units (quartile 1 = lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period.
Data Collection/Extraction Methods
Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD.
Principal Findings
Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3.
Conclusions
Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals.</description><subject>AB394</subject><subject>Acute services</subject><subject>Adult</subject><subject>California</subject><subject>Child</subject><subject>Economics, Hospital</subject><subject>Financial performance</subject><subject>Health care costs</subject><subject>Health planning</subject><subject>Hospital Costs</subject><subject>Hospitals</subject><subject>Hospitals, General - economics</subject><subject>Humans</subject><subject>Legislation</subject><subject>Legislation, Hospital - economics</subject><subject>Medical care, Cost of</subject><subject>Medicare</subject><subject>Models, Econometric</subject><subject>Nurse staffing ratios</subject><subject>Nurses</subject><subject>Nursing services</subject><subject>Nursing Staff, Hospital - economics</subject><subject>Nursing Staff, Hospital - supply & distribution</subject><subject>Original</subject><subject>Personnel Staffing and Scheduling - economics</subject><subject>Personnel Staffing and Scheduling - legislation & jurisprudence</subject><subject>Ratios</subject><subject>Regression Analysis</subject><subject>Staffing</subject><subject>Studies</subject><subject>Surveys</subject><subject>Workforce</subject><subject>Workforce planning</subject><issn>0017-9124</issn><issn>1475-6773</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>N95</sourceid><sourceid>7QJ</sourceid><recordid>eNqNk22L1DAQx4so3nr6FSQgiIKteWib5o1wLHe3wnonnqL4JmTTtJs1Tdam1b1vb-qtu1tZxBaaJvObYf6ZmSgCCCYoPK9XCUppFueUkgRDhBKISJYnm3vRZGe4H00gRDRmCKcn0SPvVxDCghTpw-gEY5TBHNNJ9OWdtrrpG3DVt16Bm05UlbY1mKtaeyM67SwQtgTdUoELbYWVWhjwXrWVa5uwU8BVYCqMDnurBZg5v9adMP5x9KAKi3qyXU-jTxfnH6ezeH59-XZ6No9rirI8LiSuCM0zjCumJBMSYVogVg7plYRRyaoFSXGwLdhCKkbKIIKSDGJUUpkW5DR6cxd33S8aVUplu1YYvm51I9pb7oTmY4vVS167H5wQQlmahwAvtgFa971XvuON9lIZI6xyvecIYgJZjvH_oAhjyFKEAvrsL3Tl-taGmxgolGZZztieqoVRXNvKhRTlEJSfYZajHMKUBCo-QtXKqqDHWVXpcDzikyN8eEvVaHnU4eXIITCd2nS16L3nxeX8X8lsWemMUbXiobbT6zH__IBfKmG6pXemHzrLj8FXB-Ci99oqHz5e18vO3-Uywp8e1n1X8D-tvW-Mn0Ht7c6OIB9GiK_4MCl8mBQ-jBD_PUJ8w2fnNx-G371S7YPCXQDRfgteJPh-vrrkXyGZsYIGd_ILmhgXrw</recordid><startdate>201206</startdate><enddate>201206</enddate><creator>Reiter, Kristin L.</creator><creator>Harless, David W.</creator><creator>Pink, George H.</creator><creator>Mark, Barbara A.</creator><general>Blackwell Publishing Ltd</general><general>Health Research and Educational Trust</general><general>Blackwell Science Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>N95</scope><scope>XI7</scope><scope>8GL</scope><scope>7QJ</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201206</creationdate><title>Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals</title><author>Reiter, Kristin L. ; Harless, David W. ; Pink, George H. ; Mark, Barbara A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g7156-8c2f376522f9ec9ac127819d5062d397c9fb3429ecb9bce93d008735021d7c483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>AB394</topic><topic>Acute services</topic><topic>Adult</topic><topic>California</topic><topic>Child</topic><topic>Economics, Hospital</topic><topic>Financial performance</topic><topic>Health care costs</topic><topic>Health planning</topic><topic>Hospital Costs</topic><topic>Hospitals</topic><topic>Hospitals, General - economics</topic><topic>Humans</topic><topic>Legislation</topic><topic>Legislation, Hospital - economics</topic><topic>Medical care, Cost of</topic><topic>Medicare</topic><topic>Models, Econometric</topic><topic>Nurse staffing ratios</topic><topic>Nurses</topic><topic>Nursing services</topic><topic>Nursing Staff, Hospital - economics</topic><topic>Nursing Staff, Hospital - supply & distribution</topic><topic>Original</topic><topic>Personnel Staffing and Scheduling - economics</topic><topic>Personnel Staffing and Scheduling - legislation & jurisprudence</topic><topic>Ratios</topic><topic>Regression Analysis</topic><topic>Staffing</topic><topic>Studies</topic><topic>Surveys</topic><topic>Workforce</topic><topic>Workforce planning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Reiter, Kristin L.</creatorcontrib><creatorcontrib>Harless, David W.</creatorcontrib><creatorcontrib>Pink, George H.</creatorcontrib><creatorcontrib>Mark, Barbara A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Gale Business: Insights</collection><collection>Business Insights: Essentials</collection><collection>Gale In Context: High School</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Health services research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Reiter, Kristin L.</au><au>Harless, David W.</au><au>Pink, George H.</au><au>Mark, Barbara A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals</atitle><jtitle>Health services research</jtitle><addtitle>Health Serv Res</addtitle><date>2012-06</date><risdate>2012</risdate><volume>47</volume><issue>3pt1</issue><spage>1030</spage><epage>1050</epage><pages>1030-1050</pages><issn>0017-9124</issn><eissn>1475-6773</eissn><coden>HESEA5</coden><abstract>Objective
To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance.
Data Sources/Study Setting
Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states.
Study Design
The study employs a difference‐in‐difference analytical approach. Hospitals are grouped into quartiles based on pre‐regulation nurse staffing levels in adult medical‐surgical and pediatric units (quartile 1 = lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period.
Data Collection/Extraction Methods
Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD.
Principal Findings
Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3.
Conclusions
Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>22150627</pmid><doi>10.1111/j.1475-6773.2011.01356.x</doi><tpages>21</tpages><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection |
| subjects | AB394 Acute services Adult California Child Economics, Hospital Financial performance Health care costs Health planning Hospital Costs Hospitals Hospitals, General - economics Humans Legislation Legislation, Hospital - economics Medical care, Cost of Medicare Models, Econometric Nurse staffing ratios Nurses Nursing services Nursing Staff, Hospital - economics Nursing Staff, Hospital - supply & distribution Original Personnel Staffing and Scheduling - economics Personnel Staffing and Scheduling - legislation & jurisprudence Ratios Regression Analysis Staffing Studies Surveys Workforce Workforce planning |
| title | Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals |
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