Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States.
Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States.
Heart Lung. 2021 Mar-Apr;50(2):206-212. doi: 10.1016/j.hrtlng.2020.12.001. Epub 2020 Dec 8.
Nurse staffing impacts patient outcomes, but little is known about the relationship between nurse staffing and outcomes for lung cancer patients undergoing pulmonary lobectomy.
To examine the association between nurse staffing and outcomes following lobectomy for lung cancer.
Patients (N = 16,994) with lung cancer between who underwent lobectomy between 2008-2011 were identified in the National Inpatient Sample. Nurse staffing was quantified using registered nurse full-time equivalents per adjusted patient days. Multivariable models were used to estimate the effect of RN FTEs on mortality, length of stay, and costs, controlling for covariates.
Patients treated at hospitals using 5.6 or more RN FTEs had shorter hospitals stays by 0.37 days (p = 0.008), had 36% lower odds of mortality (OR = 0.64, p = 0.014), but incurred $4,388 (p < 0.0001) in additional costs.
Hospital administrators face a troubling trade-off between costs and outcomes in decisions about nurse staffing mix for pulmonary lobectomy.
护士人力配置会影响患者的预后，但对于护士人力配置与接受肺叶切除术的肺癌患者预后之间的关系，人们知之甚少。
探讨肺叶切除术后护士人力配置与肺癌患者预后的关系。
从 2008 年至 2011 年接受肺叶切除术的肺癌患者中，在国家住院样本（National Inpatient Sample）中确定了 16994 名患者。采用每例调整后患者天数的注册护士全职当量（registered nurse full-time equivalents）来量化护士人力配置。采用多变量模型，控制协变量，估计 RN FTEs 对死亡率、住院时间和成本的影响。
在使用 5.6 个或更多 RN FTEs 的医院治疗的患者，其住院时间缩短了 0.37 天（p=0.008），死亡率降低了 36%（OR=0.64，p=0.014），但额外增加了 4388 美元的费用（p<0.0001）。
在决定肺叶切除术的护士人力配置组合时，医院管理者在成本和结果之间面临着一个令人困扰的权衡。
