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How many nurses do we need? What’s the right skill mix?

Nursing represents 44 percent of hospital labor costs, according to this analysis of  the 2008 Occupational Mix Survey conducted every other year by the Centers for Medicare & Medicaid Services.  Therefore, the authors calculate that nursing represents about a quarter of total hospital expenditures.  This study uses data from the CMS survey to compare nursing costs, staffing ratios, and skill mix among urban versus rural hospitals of different ownership types (government, nonprofit, and proprietary).  Among the findings (for acute care hospitals):

  • Urban nonprofit hospitals are generally larger than other hospitals (average size = 254 beds)
  • Rural hospitals of all ownership types are more heavily dependent on Medicare (about 59 percent of payor mix)
  • Nonprofit urban hospitals have a skill mix with the most RNs
  • The RN-to-bed ratio is highest in urban government and urban nonprofit hospitals

The authors found a statistically significant differences between hospitals by ownership type, with proprietary hospitals found to have leaner labor costs.  No conclusions were drawn about implications for quality of care or efficiency. 

Why I like this article:  It’s a large-scale study that provides interesting nurse staffing benchmarks.

Source:  Welton, J.M.  Hospital nursing workforce costs, wages, occupational mix, and resource utilization.  JONA. Journal of Nursing Administration;41(7/8):309-314, July/August 2011.  Full text here: http://journals.lww.com/jonajournal/Abstract/2011/07000/Hospital_Nursing_Workforce_Costs,_Wages,.6.aspx Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

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