| n an era of patient centered, value-based health care, the value of the largest labor sector in the hospital setting, the nurse, is unknown. Traditional methods of accounting for nursing services have included measuring nursing hours per patient day, which is a unit level measurement that does not include variability in nursing care at the patient level. The purpose of the study was 1) to explore the variability of nursing cost per acute care episode for patients with similar DRGs with or without major complications; 2) to investigate the relationship among patient characteristics, nurse characteristics, nursing intensity, and nursing cost as a patient outcome. A retrospective, exploratory, cost study using secondary patient level data was completed. The study site was one general medical surgical unit in a large academic medical center. De-identified data from three databases were merged into a single file and analyzed using Stata software. Correlation analysis and regression analysis were used to explore relationships among patient characteristics, nursing characteristics, and nursing cost per acute care episode. Microeconometric measurement was used to determine the elasticity of nursing characteristics on acuity and nursing cost. Key findings included 1) patients with the same diagnosis have large variability in nursing intensity and nursing cost by shift, day and acute care episode; 2) nurses may not be assigned patients based on experience and education level; 3) direct nursing cost per patient on the study unit was... |
