NURSE STAFFING PATTERNS AND HOSPITAL EFFICIENCY IN THE UNITED-STATES

The objective of this exploratory study was to assess the effects of f our nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; par t-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were spe cified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of addit ional variables were also included in the models to control for the ef fect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-perso nnel operating costs. An RN rich skill mix was not related to either m easure of hospital costs. These findings provide partial support of th e theory. Implications of our findings for future research on hospital management are discussed. Copyright (C) 1997 Elsevier Science Ltd