IDEAS home Printed from https://ideas.repec.org/p/zbw/rwirep/724.html
   My bibliography  Save this paper

The relationship between nurse staffing levels and objective and subjective quality of care: A panel data approach for Germany

Author

Listed:
  • Augurzky, Boris
  • Bünnings, Christian
  • Wübker, Ansgar

Abstract

In this study we investigate the relationship between nursing staffing levels and hospital quality in Germany. We use administrative data from almost all German hospitals from 2002 to 2013 and link it to mortality rates and patient satisfaction measures. To analyze the association between nursing staffing levels and hospital quality indicators empirically, we estimate linear regression models and control for a wide range of hospital and patient characteristics that might bias the results. In addition, we exploit the longitudinal structure of the data and rule out potential bias due to time-invariant unobserved heterogeneity. The estimation results indicate a positive relationship between nurse staffing levels and hospital quality for both subjective and objective quality measures. Increasing nurse staffing levels by 10 percent reduces the mortality rate by 0.05 percent and increases patient satisfaction by around 0.7 percent, on average. Although we find some of these relationships to be statistically significant, at least marginally, the absolute magnitudes of the estimated coefficients are rather small.

Suggested Citation

  • Augurzky, Boris & Bünnings, Christian & Wübker, Ansgar, 2017. "The relationship between nurse staffing levels and objective and subjective quality of care: A panel data approach for Germany," Ruhr Economic Papers 724, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    • Handle: RePEc:zbw:rwirep:724
    DOI: 10.4419/86788844
    as

    Download full text from publisher

    File URL: https://www.econstor.eu/bitstream/10419/172476/1/rep_17_724.pdf
    Download Restriction: no
    File URL: https://libkey.io/10.4419/86788844?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
    ---><---

    References listed on IDEAS

    as
    1. Augurzky, Boris & Bünnings, Christian & Dördelmann, Sandra & Greiner, Wolfgang & Hein, Lorenz & Scholz, Stefan & Wübker, Ansgar, 2016. "Die Zukunft der Pflege im Krankenhaus: Forschungsprojekt im Auftrag der Techniker Krankenkasse," RWI Materialien 104, RWI - Leibniz-Institut für Wirtschaftsforschung.
    2. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Karina Dietermann & Vera Winter & Udo Schneider & Jonas Schreyögg, 2021. "The impact of nurse staffing levels on nursing-sensitive patient outcomes: a multilevel regression approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 833-846, July.
    2. Salm, Martin & Wübker, Ansgar, 2018. "Do higher hospital reimbursement prices improve quality of care?," Ruhr Economic Papers 779, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.

    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. John R. Bowblis & Andrew Ghattas, 2017. "The Impact of Minimum Quality Standard Regulations on Nursing Home Staffing, Quality, and Exit Decisions," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 50(1), pages 43-68, February.
    2. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    3. Joshua D. Gottlieb & Avi Zenilman, 2020. "When Workers Travel: Nursing Supply During COVID-19 Surges," NBER Working Papers 28240, National Bureau of Economic Research, Inc.
    4. Cristina Borra & Jerònia Pons-Pons & Margarita Vilar-Rodríguez, 2020. "Austerity, healthcare provision, and health outcomes in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 409-423, April.
    5. Raja, Chandni, 2023. "How do hospitals respond to input regulation? Evidence from the California nurse staffing mandate," Journal of Health Economics, Elsevier, vol. 92(C).
    6. Jean-Baptiste Combes & Eric Delattre & Bob Elliott & Diane Skåtun, 2015. "Hospital staffing and local pay: an investigation into the impact of local variations in the competitiveness of nurses’ pay on the staffing of hospitals in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(7), pages 763-780, September.
    7. Marina Di Giacomo & Massimiliano Piacenza & Luca Salmasi & Gilberto Turati, 2024. "Understanding productivity in maternity wards," DISCE - Working Papers del Dipartimento di Economia e Finanza def134, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    8. Maibom, Jonas & Sievertsen, Hans H. & Simonsen, Marianne & Wüst, Miriam, 2021. "Maternity ward crowding, procedure use, and child health," Journal of Health Economics, Elsevier, vol. 75(C).
    9. Michael DiNardi, 2017. "Affordable Care Act Medicaid Expansions and the Impact on Nurses," 2017 Papers pdi509, Job Market Papers.
    10. Joshua D. Gottlieb & Avi Zenilman, 2020. "When Nurses Travel: Labor Supply Elasticity During COVID-19 Surges," Working Papers 2020-166, Becker Friedman Institute for Research In Economics.
    11. 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.
    12. Andrea Ciaccio, 2023. "The Impact of a Cost-containment Measure on the Quality of Regional Health Services in Italy: a Parametric and a Non-parametric Approach," Working Papers 2023: 24, Department of Economics, University of Venice "Ca' Foscari".
    13. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    14. Kai Fischer, 2023. "Skilled Labour Migration and Firm Performance: Evidence from English Hospitals and Brexit," CESifo Working Paper Series 10747, CESifo.
    15. Nan Jiang & Gail Pacheco, 2014. "Demand in New Zealand hospitals: expect the unexpected?," Applied Economics, Taylor & Francis Journals, vol. 46(36), pages 4475-4489, December.
    16. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    17. Matthew C. Harris & Yinan Liu & Ian McCarthy, 2019. "Capacity Constraints and the Provision of Public Services: The Case of Workers in Public Health Clinics," NBER Working Papers 25706, National Bureau of Economic Research, Inc.
    18. Traczynski, Jeffrey & Udalova, Victoria, 2018. "Nurse practitioner independence, health care utilization, and health outcomes," Journal of Health Economics, Elsevier, vol. 58(C), pages 90-109.
    19. 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.
    20. Karina Dietermann & Vera Winter & Udo Schneider & Jonas Schreyögg, 2021. "The impact of nurse staffing levels on nursing-sensitive patient outcomes: a multilevel regression approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 833-846, July.

    More about this item

    Keywords

    Hospital quality; nurse staffing; patient satisfaction; mortality rate;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:zbw:rwirep:724. 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: ZBW - Leibniz Information Centre for Economics (email available below). General contact details of provider: https://edirc.repec.org/data/rwiesde.html .

    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.