School of Nursing & Health Sciences, Florida Southern College, Lakeland, USA.
J Nurs Adm. 2011 Jul-Aug;41(7-8):309-14. doi: 10.1097/NNA.0b013e3182250a2b.
: The objective of the study was to better understand how hospitals use different types of RNs, LPNs, and nurse aides in proprietary (for-profit), nonprofit, and government-owned hospitals and to estimate the wages, cost, and intensity of nursing care using a national data set.
: This is a cross-sectional observational study of 3,129 acute care hospitals in all 50 states and District of Columbia using data from the 2008 Occupational Mix Survey administered by the Centers for Medicare & Medicaid Services (CMS). Nursing skill mix, hours, and labor costs were combined with other CMS hospital descriptive data, including type of hospital ownership, urban or rural location, hospital beds, and case-mix index.
: RN labor costs make up 25.5% of all hospital expenditures annually, and all nursing labor costs represent 30.1%, which is nearly a quarter trillion dollars ($216.7 billion) per year for inpatient nursing care. On average, proprietary hospitals employ 1.3 RNs per bed and 1.9 nursing personnel per bed in urban hospitals compared with 1.7 RNs per bed and 2.3 nursing personnel per bed for nonprofit and government-owned hospitals (P < .05). States with higher ratios of RN compared with LPN licenses used fewer LPNs in the inpatient setting.
: The findings from this study can be helpful in comparing nursing care across different types of hospitals, ownership, and geographic locations and used as a benchmark for future nursing workforce needs and costs.
本研究旨在更好地了解营利性、非营利性和政府所有医院如何使用不同类型的注册护士（RN）、执业护师（LPN）和护士助理，并使用国家数据集来估计护理服务的工资、成本和强度。
这是一项对全美 50 个州和哥伦比亚特区的 3129 家急症护理医院进行的横断面观察性研究，使用了医疗保险和医疗补助服务中心（CMS）进行的 2008 年职业组合调查的数据。护理技能组合、工作时间和劳动力成本与 CMS 医院描述性数据相结合，包括医院所有权类型、城市或农村位置、医院床位和病例组合指数。
RN 劳动力成本占医院每年总支出的 25.5%，所有护理劳动力成本占 30.1%，即每年用于住院护理的护理劳动力成本近 2167 亿美元。与非营利性和政府所有医院相比，营利性医院在城市医院中每床雇用 1.3 名 RN 和 1.9 名护理人员，而非营利性和政府所有医院每床雇用 1.7 名 RN 和 2.3 名护理人员（P <.05）。RN 执照与 LPN 执照之比较高的州，在住院环境中使用的 LPN 较少。
本研究的结果有助于比较不同类型、所有权和地理位置的医院的护理服务，并可作为未来护理劳动力需求和成本的基准。
