Comparison of nursing staffing ratio in selected safety net and non-safety net hospitals in the United States

Abstract

Objective: This study investigated the differential association between nurse staffing in safety-net hospitals (SNHs) and non- SNHs.
Methods: This retrospective cross-sectional study utilized multilevel mixed-effects linear regression models and included data from 1,228 hospitals.
Results: The results showed that SNHs in the top quartile of disproportionate share hospital (DSH) payments had lower nurse staffing ratios (β = -0.86; p-value <.001), indicating a lower nurse-to-patient ratio, compared to non-SNHs. This association persisted even after adjusting for the county and hospital factors.
Conclusions: These findings suggest that nurse staffing in SNHs may be impacted by the financial challenges associated with providing uncompensated care to vulnerable populations. Understanding the differences in nurse staffing between SNHs and non-SNHs can provide insights for improving quality of care. Further research is required to explore the impact of nurse staffing on patient outcomes in SNHs.

Keywords

Nurse staffing ratio / Safety-net hospitals / Hospital characteristics / Community hospital / Quality care

ACKNOWLEDGEMENTS

Not Applicable

AUTHORS CONTRIBUTIONS

NZ and HYH led the conceptualization of the study; AFT, HYH and AS gathered and integrated the data; NZ, AFT, HYH, MZ, DRH and AS wrote the first and subsequent drafts; HYH created the tables, and MZ completed the revisions of the final draft; AFT and AS completed editing of the final draft. NZ, MZ and DRH validated the data and presentation. HYH reviewed and provided edits to the final draft, and supervised the project.

ETHICAL STATEMENT

Informed patient consent was not required because no patient clinical or identity data was collected, and no patient interventions were completed during the course of study. Therefore ethical review board approval was not required and waived.

FUNDING

This work has no external financial support.

CONFLICTS OF INTEREST DISCLOSURE

The author declares that there is no conflicts of interest.

ETHICS APPROVAL

The Publication Ethics Committee of the Sciedu Press. The journal’s policies adhere to the Core Practices established by the Committee on Publication Ethics (COPE).

PROVENANCE AND PEER REVIEW

Not commissioned; externally double-blind peer reviewed.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

DATA SHARING STATEMENT

No additional data are available.

OPEN ACCESS

This is an open-access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/4.0/).

COPYRIGHTS

Copyright for this article is retained by the author(s), with first publication rights granted to the journal.

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