IDEAS home Printed from https://ideas.repec.org/a/eee/jhecon/v31y2012i2p340-348.html
   My bibliography  Save this article

The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation

Author

Listed:
  • Cook, Andrew
  • Gaynor, Martin
  • Stephens Jr, Melvin
  • Taylor, Lowell

Abstract

We evaluate the impact of California Assembly Bill 394, which mandated maximum levels of patients per nurse in the hospital setting. When the law was passed, some hospitals already met the requirements, while others did not. Thus changes in staffing ratios from the pre- to post-mandate periods are driven in part by the legislation. We find persuasive evidence that AB394 had the intended effect of decreasing patient/nurse ratios in hospitals that previously did not meet mandated standards. However, these improvements in staffing ratios do not appear to be associated with relative improvements in measured patient safety in affected hospitals.

Suggested Citation

  • Cook, Andrew & Gaynor, Martin & Stephens Jr, Melvin & Taylor, Lowell, 2012. "The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation," Journal of Health Economics, Elsevier, vol. 31(2), pages 340-348.
    • Handle: RePEc:eee:jhecon:v:31:y:2012:i:2:p:340-348
    DOI: 10.1016/j.jhealeco.2012.01.005
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167629612000069
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jhealeco.2012.01.005?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Carol Propper & John Van Reenen, 2010. "Can Pay Regulation Kill? Panel Data Evidence on the Effect of Labor Markets on Hospital Performance," Journal of Political Economy, University of Chicago Press, vol. 118(2), pages 222-273, April.
    2. McClellan Mark & Staiger Douglas, 2000. "Comparing the Quality of Health Care Providers," Forum for Health Economics & Policy, De Gruyter, vol. 3(1), pages 1-26, January.
    3. Evans, William N. & Kim, Beomsoo, 2006. "Patient outcomes when hospitals experience a surge in admissions," Journal of Health Economics, Elsevier, vol. 25(2), pages 365-388, March.
    4. Douglas Staiger & James H. Stock, 1997. "Instrumental Variables Regression with Weak Instruments," Econometrica, Econometric Society, vol. 65(3), pages 557-586, May.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kleiner, Samuel A., 2019. "Hospital treatment and patient outcomes: Evidence from capacity constraints," Journal of Public Economics, Elsevier, vol. 175(C), pages 94-118.
    2. Arindrajit Dube & Ethan Kaplan & Owen Thompson, 2016. "Nurse Unions and Patient Outcomes," ILR Review, Cornell University, ILR School, vol. 69(4), pages 803-833, August.
    3. Kai Fischer, 2023. "Skilled Labour Migration and Firm Performance: Evidence from English Hospitals and Brexit," CESifo Working Paper Series 10747, CESifo.
    4. Tom Stargardt & Jonas Schreyögg & Ivan Kondofersky, 2014. "Measuring The Relationship Between Costs And Outcomes: The Example Of Acute Myocardial Infarction In German Hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 23(6), pages 653-669, June.
    5. Ann P. Bartel & Ciaran S. Phibbs & Nancy Beaulieu & Patricia Stone, 2011. "Human Capital and Organizational Performance: Evidence from the Healthcare Sector," NBER Working Papers 17474, National Bureau of Economic Research, Inc.
    6. Yaa Akosa Antwi & John R. Bowblis, 2018. "The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession," American Journal of Health Economics, MIT Press, vol. 4(2), pages 131-163, Spring.
    7. Laudicella, Mauro & Li Donni, Paolo & Smith, Peter C., 2013. "Hospital readmission rates: Signal of failure or success?," Journal of Health Economics, Elsevier, vol. 32(5), pages 909-921.
    8. Francesco Longo & Karl Claxton & Stephen Martin & James Lomas, 2023. "More long‐term care for better healthcare and vice versa: investigating the mortality effects of interactions between these public sectors," Fiscal Studies, John Wiley & Sons, vol. 44(2), pages 189-216, June.
    9. Patricia K. Tong, 2011. "The effects of California minimum nurse staffing laws on nurse labor and patient mortality in skilled nursing facilities," Health Economics, John Wiley & Sons, Ltd., vol. 20(7), pages 802-816, July.
    10. Vieira, Flávio & MacDonald, Ronald & Damasceno, Aderbal, 2012. "The role of institutions in cross-section income and panel data growth models: A deeper investigation on the weakness and proliferation of instruments," Journal of Comparative Economics, Elsevier, vol. 40(1), pages 127-140.
    11. Anthony Briant & Pierre-Philippe Combes & Miren Lafourcade, 2014. "Product Complexity, Quality of Institutions and the Protrade Effect of Immigrants," The World Economy, Wiley Blackwell, vol. 37(1), pages 63-85, January.
    12. Mario Jametti & Thomas von Ungern-Sternberg, 2005. "Assessing the Efficiency of an Insurance Provider—A Measurement Error Approach," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 30(1), pages 15-34, June.
    13. Yane, Haruka & Yamada, Hiroyuki, 2015. "Import Competition from Neighbors: Impacts on Performances of Enterprises in Vietnam," Conference papers 332621, Purdue University, Center for Global Trade Analysis, Global Trade Analysis Project.
    14. Isaiah Andrews & Anna Mikusheva, 2016. "Conditional Inference With a Functional Nuisance Parameter," Econometrica, Econometric Society, vol. 84, pages 1571-1612, July.
    15. McCausland, David & Pouliakas, Konstantinos & Theodossiou, Ioannis, 2005. "Some are Punished and Some are Rewarded: A Study of the Impact of Performance Pay on Job Satisfaction," MPRA Paper 14243, University Library of Munich, Germany.
    16. Markus Brueckner & Daniel Lederman, 2018. "Inequality and economic growth: the role of initial income," Journal of Economic Growth, Springer, vol. 23(3), pages 341-366, September.
    17. Caroline Flammer & Michael W. Toffel & Kala Viswanathan, 2021. "Shareholder activism and firms' voluntary disclosure of climate change risks," Strategic Management Journal, Wiley Blackwell, vol. 42(10), pages 1850-1879, October.
    18. Hebous, Shafik & Zimmermann, Tom, 2014. "Revisiting the Narrative Approach of Estimating Fiscal Multipliers," VfS Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100408, Verein für Socialpolitik / German Economic Association.
    19. Gordon Dahl, 2010. "Early teen marriage and future poverty," Demography, Springer;Population Association of America (PAA), vol. 47(3), pages 689-718, August.
    20. Christoph Schwierz & Boris Augurzky & Axel Focke & Jürgen Wasem, 2012. "Demand, selection and patient outcomes in German acute care hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 209-221, March.

    More about this item

    Keywords

    Nursing; Staffing; Regulation; Outcomes; Hospitals; Patient safety;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:31:y:2012:i:2:p:340-348. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/inca/505560 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.