Abstract
Objective: This study investigated the differential association between nurse staffing in safety-net hospitals (SNHs) and non-SNHs.Methods: This retrospective cross-sectional study utilized multilevel mixed-effects linear regression models and included data from 1,228 hospitals.Results: The results showed that SNHs in the top quartile of disproportionate share hospital (DSH) payments had lower nurse staffing ratios (β = -0.86; p-value < .001), indicating a lower nurse-to-patient ratio, compared to non-SNHs. This association persisted even after adjusting for the county and hospital factors.Conclusions: These findings suggest that nurse staffing in SNHs may be impacted by the financial challenges associated with providing uncompensated care to vulnerable populations. Understanding the differences in nurse staffing between SNHs and non-SNHs can provide insights for improving quality of care. Further research is required to explore the impact of nurse staffing on patient outcomes in SNHs.
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