Economic Impact Of Nurse Sensitive Outcomes In Irish Hospitals

Abstract

Since the financial crisis of 2008 there has been increased pressure on public health care services like that in Ireland to “do more with less”. This has direct consequences for front line personnel such as nurses, whose work load has increased in subsequent years. Also during this time technologies are advancing and the availability of treatment interventions in and outside of hospitals is increasing, placing increased demands on already scarce resources. As a result front line staff, such as nurses, had to increase their workloads care and provide efficiencies. Recently, nurse sensitive outcomes are used as a means of evaluating nurse staffing. Nurse sensitive outcomes are adverse events sensitive to nursing which are often reported as secondary diagnoses but have an economic impact on an episode of care. This study estimates of nurse sensitive outcomes on inpatient casemix costs in Ireland. Data (N=2,014) was sourced from patient discharge information from six acute wards amongst three Irish hospitals from July 2016 to January 2017. (These hospitals were enrolled in national pilot of a Nurse Safe Staffing and Skill-Mix Project.) The National Ready Reckoner DRGs (version 8) was used to value the relevant inpatient casemix cost per case (i.e. episode of care) for each patient from the health care provider’s perspective. Ordinary least squares regression was performed (Stata version 14) to estimate the impact of nurse sensitive outcome on inpatient casemix cost per case. Controlling for length of stay the average cost associated with the presence of a nurse sensitivity outcome is estimated to be €1,093 (p=0.011). Nurse sensitive outcomes do impact on inpatient costs. The estimated average cost of nurse sensitive outcomes can be used to estimate the cost of nurse sensitive outcomes avoided in economic evaluations, budget impact analysis etc. of interventions in an acute care settings.