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The Effect of a Hospital Nurse Staffing Mandate on Patient Health Outcomes: Evidence from California’s Minimum Staffing Regulation

Author

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

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

  • Andrew Cook & Martin Gaynor & Melvin Stephens, Jr. & Lowell Taylor, 2012. "The Effect of a Hospital Nurse Staffing Mandate on Patient Health Outcomes: Evidence from California’s Minimum Staffing Regulation," The Centre for Market and Public Organisation 12/283, The Centre for Market and Public Organisation, University of Bristol, UK.
    • Handle: RePEc:bri:cmpowp:12/283
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    File URL: http://www.bristol.ac.uk/cmpo/publications/papers/2012/wp283.pdf
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    References listed on IDEAS

    as
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    4. 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.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

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

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K2 - Law and Economics - - Regulation and Business Law

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