Is there an economic case for investing in nursing care - what does the literature tell us?

Journal of Advanced Nursing

Volumn 71, Issue 5, 2015, Pages 975-990

  Twigg, Diane E ^a,b   Myers, Helen ^a   Duffield, Christine ^a,c   Giles, Margaret ^a   Evans, Gemma ^a  

^a EDITH COWAN UNIVERSITY   (Australia)

^b SIR CHARLES GAIRDNER HOSPITAL   (Australia)

^c UNIVERSITY OF TECHNOLOGY SYDNEY   (Australia)

Author keywords

Acute care; Economic evaluation; Literature review; Nurse sensitive outcomes; Nurse skill mix; Nurse staffing; Nursing; Patient outcomes

Indexed keywords

CLINICAL COMPETENCE; HEALTH ECONOMICS; NURSING CARE; PERSONNEL MANAGEMENT;

CLINICAL COMPETENCE; ECONOMICS, NURSING; NURSING CARE; PERSONNEL STAFFING AND SCHEDULING;

EID: 84927154658     PISSN: 03092402     EISSN: 13652648     Source Type: Journal    
DOI: 10.1111/jan.12577     Document Type: Review

References (58)

1. Aiken L.H., Clarke S.P., Sloane D.M., Sochalski J. & Silber J.H. (2002) Hospital nurse staffing and patient mortality, nurse burnout and job dissatisfaction. Journal of the American Medical Association 288, 1987-1993. doi:10.1001/jama.288.16.1987.
2. Aiken L.H., Clarke S.P., Cheung R.B., Sloane D.M. & Silber J.H. (2003) Education levels of hospital nurses and surgical patient mortality. Journal of the American Medical Association 290, 1617-1623. doi:10.1001/jama.290.12.1617.
3. Aiken L.H., Sloane D.M., Bruyneel L., Van den Heede K., Griffiths P., Busse R., Diomidous M., Kinnunen J., Kozka M., Lessafre E., McHugh M.D., Moreno-Casbas M.T., Rafferty A.M., Schwendimann R., Scott P.A., Tishelman C., van Achterberg T. & Sermeus W. (2014) Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet 383, 1-7. doi:10.1016/S0140-6736(13)62631-8
4. Behner K.G., Fogg L.F., Fournier L.C., Frankenbach J.T. & Robertson S.B. (1990) Nursing resource management: analysing the relationship between costs and quality in staffing decisions. Health Care Management Review 15, 63-71. doi:10.1097/00004010-199001540-00008.
5. Canadian Agency for Drugs and Technology in Health (2006) Guidelines for the Economic Evaluation of Health Technologies: Canada, 3rd edn. Canadian Agency for Drugs and Technology in Health, Ottawa, ON.
6. Chiou C., Hay J.W., Wallace J.F., Bloom B.S., Neumann P.J., Sullivan S.D., Yu H., Keeler E.B., Henning J.M. & Ofman J.J. (2003) Development and validation of a grading system for the quality of cost-effectiveness studies. Medical Care 41, 32-44. doi:10.1097/00005650-200301000-00007.
7. Cho S., Ketefian S., Barkauskas V.H. & Smith D.G. (2003) The effects of nurse staffing on adverse events, morbidity, mortality and medical costs. Nursing Research 52, 71-79. doi:10.1097/00006199-200303000-00003.
8. Dall T.M., Chen Y.J., Seifert R.F., Maddox P.J. & Hogan P.F. (2009) The economic value of professional nursing. Medical Care 47, 97-104. doi:10.1097/MLR.0b013e3181844da8.
9. Deloitte Centre for Health Solutions (2012) Issue Brief: The New Health Care Workforce: Looking Around the Corner to Future Talent Management. Deloitte, Washington, DC.
10. Drummond M.F., Sculpher M.J., Torrance G.W., O'Brien B.J. & Stoddart G.L. (2005) Methods for the Economic Evaluation of Health Care Programmes, 3rd edn. Oxford University Press, Oxford.
11. Dubois C., McKee M. & Rechel B. (2006) Critical challenges facing the health care workforce in Europe. In The Healthcare Workforce in Europe: Learning from Experience (Rechel B., Dubois C. & McKee M., eds), European Observatory on Health Systems and Policies, Trowbridge, pp. 1-18.
12. Duffield C., Diers D., O'Brien-Pallas L., Aisbett C., Roche M., King M. & Aisbett K. (2011) Nursing staffing, nursing workload, the work environment and patient outcomes. Applied Nursing Research 24, 244-255. doi:10.1016/j.apnr.2009.12.004.
13. Ehsani J.P., Jackson T. & Duckett S. (2006) The incidence and cost of adverse events in Victorian hospitals 2003-2004. Medical Journal of Australia 184, 551-555.
14. Flood S.D. & Diers D. (1988) Nurse staffing, patient outcome and cost. Nursing Management 19, 34-43. doi:10.1097/00006247-198805000-00008.
15. George B., Harris A. & Mitchell A. (2001) Cost-effectiveness analysis and the consistency of decision making: evidence from pharmaceutical reimbursement in Australia (1991 to 1996). Pharmacoeconomics 19, 1103-1109. doi:10.2165/00019053-200119110-00004.
16. Goryakin Y., Griffiths P. & Maben J. (2011) Economic evaluation of nurse staffing and nurse substitution in health care: a scoping review. International Journal of Nursing Studies 48, 501-512. doi:10.1016/j.ijnurstu.2010.07.018.
17. Gray A.M., Clarke P.M., Wolstenholme J.L. & Wordsworth S. (2012) Applied Methods of Cost-Effectiveness Analysis in Health Care. Oxford University Press, Oxford.
18. Haddix A.C., Teutsch S.M. & Corso P.S. (2003) Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation, 2nd edn. Oxford University Press, Oxford.
19. Health and Social Care Information Centre (2013) NHS Workforce Statistics, September 2013, Provisional Statistics. Health and Social Care Information Centre, Leeds.
20. Health Workforce Australia (2013) Australia's Health Workforce Series - Health Workforce by Numbers. Health Workforce Australia, Adelaide.
21. Healthcare Cost and Utilization Project & United States Agency for Healthcare Research and Quality (2000) Welcome to HCUPnet. A Tool for Identifying, Tracking, Analysing and Comparing Statistics on Hospitals at the National Level, Regional and State Level. Agency for Healthcare Research and Quality, Rockville, MD. Retrieved from http://www.ahrq.gov/data/hcup on 29 May 2009.
22. Higgins J.P.T. & Green S. (2011) Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 [updated March 2011]. The Cochrane Collaboration, London. Retrieved from http://www.handbook.cochrane.org on 02 June 2012.
23. International Monetary Fund (2014) World Economic Outlook Database April. International Monetary Fund, Washington, DC. Retrieved from http://www.imf.org/external/pubs/ft/weo/2014/01/weodata/index.aspx on 18 August 2014.
24. Joanna Briggs Institute (2013) New JBI levels of Evidence. The Joanna Briggs Institute, Adelaide. Retrieved from http://joannabriggs.org/assets/docs/approach/JBI-Levels-of-evidence:2014.pdf on 15 August 2014.
25. Kane R.L., Shamliyan T.A., Mueller C., Duval S. & Wilt T.J. (2007a) The association of registered nurse staffing levels and patient outcomes. Medical Care 45, 1195-1203. doi:10.1097/MLR.0b013e3181468ca3.
26. Kane R.L., Shamliyan T.A., Mueller C., Duval S. & Wilt T.J. (2007b) Nursing Staffing and Quality of Patient Care. Evidence Report/Technology Assessment No. 151. Agency for Healthcare Research and Quality, Rockville, MD.
27. Kaplan R.M. & Bush J.W. (1982) Health-related quality of life measurement for evaluation research and policy analysis. Health Psychology 1, 61-80. doi:10.1037/0278-6133.1.1.61.
28. Kvidal P., Bergstrom R., Horte L.G. & Stahle E. (2000) Observed and relative survival after aortic valve replacement. Journal of the American College of Cardiology 35, 747-756. doi:10.1016/S0735-1097(99)00584-7.
29. Lang T.A., Hodge M., Olson V., Romano P.S. & Kravitz R. (2004) Nurse-patient ratios: a systematic review on the effects of nurse staffing on patient, nurse employee and hospital outcomes. Journal of Nursing Administration 34, 326-337. doi:10.1097/00005110-200407000-00005.
30. Li Y., Wong E.S., Sales A.E., Sharp N.D., Needleman J., Maciejewski M.L., Lowy E., Alt-White A.C. & Liu C. (2011) Nurse staffing and patient care costs in acute inpatient nursing units. Medical Care 49, 708-715. doi:10.1097/MLR.0b013e318223a9f1.
31. McCue M., Mark B.A. & Harless D.W. (2003) Nurse staffing, quality and financial performance. Journal of Health Care Finance 29, 54-76.
32. McGillis Hall L., Doran D. & Pink G.H. (2004) Nurse staffing models, nursing hours and patient safety outcomes. Journal of Nursing Administration 34, 41-45.
33. Michigan Nurses Association (2004) The Business Case for Reducing Patient-to-Nursing Staff Ratios and Eliminating Mandatory Overtime for Nurses. Public Policy Associated, Okemos, MI.
34. National Institute for Health and Care Excellence (2013) Guide to the Methods of Technology Appraisal 2013. National Institute for Health and Care Excellence, London. Retrieved from http://www.nice.org.uk/media/D45/1E/GuideToMethodsTechnologyAppraisal2013.pdf (accessed 12 March 2013).
35. Needleman J., Buerhaus P., Mattke S., Stewart M. & Zelevinsky K. (2002) Nurse staffing levels and the quality of care in hospitals. New England Journal of Medicine 346, 1715-1722. doi:10.1056/NEJMsa012247.
36. Needleman J., Buerhaus P.I., Stewart M., Zelevinsky K. & Mattke S. (2006) Nurse staffing in hospitals: is there a business case for quality? Health Affairs 25, 204-211. doi:10.1377/hlthaff.25.1.204.
37. Newbold D. (2008) The production economics of nursing: a discussion paper. International Journal of Nursing Studies 45, 120-128. doi:10.1016/j.ijnurstu.2007.01.007.
38. OECD (2011) Society at a Glance 2001: OECD Social Indicators. OECD Publishing, Paris.
39. Pappas S.H. (2008) The cost of nurse-sensitive adverse events. Journal of Nursing Administration 38, 230-236. doi:10.1097/01.NNA.0000312770.19481.ce.
40. Pharmaceutical Benefits Advisory Committee (2013) Guidelines for Preparing Submissions to the Pharmaceutical Benefits Advisory Committee (version 4.4). Department of Health, Canberra.
41. Rafferty A.M., Clarke S.P., Coles J., Ball J., James P., McKee M. & Aiken L.H. (2007) Outcomes of variations in hospital nurse staffing in English hospitals; cross-sectional analysis of survey data and discharge records. International Journal of Nursing Studies 44, 175-182. doi:10.1016/j.ijnurstu.2006.08.003.
42. Rothberg M.B., Abraham I., Lindenauer P.K. & Rose D.N. (2005) Improving nurse-to-patient staffing ratios as a cost-effective safety intervention. Medical Care 43, 785-791. doi:10.1097/01.mlr.0000170408.35854.fa.
43. Sergent P., Blackstone E. & Meyns B. (1997) Validation and interdependence with patient-variables of the influence of procedural variables on early and late survival after CABG. K.U. Leuven Coronary Surgery Program. European Journal of Cardiothoracic Surgery 12, 1-19. doi:10.1016/S1010-7940(97)00134-6.
44. Shamliyan T.A., Kane R.L., Mueller C., Duval S. & Wilt T.J. (2009) Cost savings associated with increased RN staffing in acute care hospitals: simulation exercise. Nursing Economics 27(302-314), 331.
45. Shekelle P.G. (2013) Nurse-patient ratios as a patient safety strategy: a systematic review. Annals of Internal Medicine 158, 404-410. doi:10.7326/0003-4819-158-5-201303051-00007.
46. Shiroiwa T., Sung Y.-K., Fukuda T., Lang H.-C., Bae S.-C. & Tsutani K. (2010) International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost-effectiveness? Health Economics 19, 422-437. doi:10.1002/hec.1481.
47. Simoens S. (2009) Health economic assessment: a methodological primer. International Journal of Environmental Research and Public Health 6, 2950-2966. doi:10.3390/ijerph6122950.
48. Spetz J. (2005) The cost and cost-effectiveness of nursing services in health care. Nursing Outlook 53, 305-309. doi:10.1016/j.outlook.2005.05.006.
49. Thungjaroenkul P., Cummings G.G. & Embleton A. (2007) The impact of nurse staffing on hospital costs and patient length of stay: a systematic review. Nursing Economics 25, 255-265.
50. Twigg D. & Duffield C. (2009) A review of workload measures: a context for a new staffing methodology in Western Australia. International Journal of Nursing Studies 46, 131-139. doi:10.1016/j.ijnurstu.2008.08.005.
51. Twigg D., Duffield C., Bremner A., Rapley P. & Finn J. (2011) The impact of the nursing hours per patient day (NHPPD) staffing method on patient outcomes: a retrospective analysis of patient and staffing data. International Journal of Nursing Studies 48, 540-548. doi:10.1016/j.ijnurstu.2010.07.013.
52. Twigg D.E., Geelhoed E.A., Bremner A.P. & Duffield C.M. (2013) The economic benefits of increased levels of nursing care in the hospital setting. Journal of Advanced Nursing 69, 2253-2261. doi:10.1111/jan.12109.
53. Unruh L. (2008) Nurse staffing and patient, nurse and financial outcomes. American Journal of Nursing 108, 62-71. doi:10.1097/01.NAJ.0000305132.33841.92.
54. Van den Heede K., Lesaffre E., Diya L., Vleugels A., Clarke S.P., Aiken L.H. & Sermeus W. (2009) The relationship between inpatient cardiac surgery mortality and nurse numbers and educational level: analysis of administrative data. International Journal of Nursing Studies 46, 796-803. doi:10.1016/j.ijnurstu.2008.12.018.
55. Van den Heede K., Simoens S., Diya L., Lesaffre E., Vleugels A. & Sermeus W. (2010) Increasing nurse staffing levels in Belgian cardiac surgery centres: a cost-effective patient safety intervention? Journal of Advanced Nursing 66, 1291-1296. doi:10.1111/j.1365-2648.2010.05307.x.
56. Walker D.G., Wilson R.F., Sharma R., Bridges J., Niessen L., Bass E.B. & Frick K. (2012) Methods Research Report: Best Practices for Conducting Economic Evaluations in Health Care: A Systematic Review of Quality Assessment Tools. Agency for Healthcare Research and Quality, Rockville, MD.
57. Weinstein M.C., Siegel J.E., Gold M.R., Kamlet M.S. & Russell L.B. (1996) Consensus statement: recommendations of the panel on cost-effectiveness in health and medicine. Journal of the American Medical Association 276, 1253-1258.
58. Weiss M.E., Yakusheva O. & Bobay K.L. (2011) Quality and cost analysis of nurse staffing, discharge preparation and postdischarge utilization. Health Services Research 46, 1473-1494. doi:10.1111/j.1475-6773.2011.01267.x.