Higher nurse-patient ratios result in societal cost benefits for some hospital areas
Research Activities, June 2010, No. 358
Increasing nurse-to-patient staffing is recommended to improve patient safety and reduce adverse advents. A recently published simulation study shows that increased registered nurse (RN) staffing was associated with lower hospital-related mortality and adverse patient events. This approach can result in societal net savings, depending on the area of the hospital.
University of Minnesota researchers analyzed data from 27 published studies on patient outcomes and nurse-to-patient ratios. They estimated hospital savings and the number of adverse events avoided. They determined the savings-cost ratio from increased nurse staffing for patients in intensive care units (ICUs) and those admitted to medical or surgical floors. Increasing nurse staffing in the ICU had the greatest positive impact on societal savings from avoided deaths and patient adverse events. The monetary benefit of saved lives per 1,000 hospitalized patients was 2.5 times higher than the increased cost of one additional full-time nurse per patient day in the ICU. It was 1.8 times higher in surgical units and 1.3 times higher in medical units.
The researchers estimated that increasing nurse staffing by one full-time nurse in the ICU would save 327,390 years of life in men and 320,988 in women. This would result in a productivity benefit of $4 billion to $5 billion dollars. In surgical units, the staffing change would result in a larger productivity benefit of $8 billion to $10 billion dollars. While these are societal net savings, hospitals do not appear to reap sufficient monetary benefit from length of stay reductions produced by increased nurse staffing. The study was supported in part by the Agency for Healthcare Research and Quality (Contract No. 290-02-0009).
See "Cost savings associated with increased RN staffing in acute care hospitals: Simulation exercise," by Tatyana A. Shamliyan, M.D., M.S., Robert L. Kane, M.D., Christine Mueller, Ph.D., R.N., and others in Nursing Economics 27(5), pp. 302-331, 2009.