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Open Access Nursing Inputs and Outcomes of Hospital Care: An Empirical Analysis of Ontario's Acute-Care Hospitals Contribution du personnel infirmier et résultats des soins hospitaliers : analyse empirique des hôpitaux de soins de courte durée de l'Ontario

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Abstract:

The authors analyze the association between intensity of nursing care (as measured by nursing hours per patient day), hospital bed days, and patient outcomes in acute-care hospitals in the province of Ontario, Canada, to determine whether higher levels of nursing inputs are associated with shorter lengths of stay (LOS) and, if so, whether these shorter LOS are achieved at the expense of health outcomes. After controlling for supply of nurses, workload, community characteristics, and hospital type, the authors found that nursing hours per patient day had a significant negative effect on LOS but had no significant effect on patient satisfaction, hospital mortality, or readmission rates. Further, there was no evidence that shorter than expected LOS were associated with poorer patient health. Such information is relevant for efforts to deploy efficient mixes of health-care resources and to identify future human resource requirements to support the efficient provision of health human resources.

French
Les auteurs de cette étude, qui porte sur les hôpitaux de soins de courte durée de l'Ontario (Canada), ont analysé le lien existant entre le degré d'utilisation des soins infirmiers (mesuré en heures de soins par jour-patient), le nombre de jours d'hospitalisation et les résultats pour les patients, dans le but de déterminer si une contribution accrue du personnel infirmier est associée à un raccourcissement des séjours hospitaliers et si, dans le cas de l'affirmative, ce raccourcissement est obtenu sans que cela nuise aux résultats pour la santé. Au terme de leur analyse, qui tient compte de l'effectif infirmier, de la charge de travail, des caractéristiques de la collectivité et du type d'hôpital, les auteurs ont constaté que le nombre d'heures de soins infirmiers avait une incidence négative significative sur la durée des séjours hospitaliers, et ce, sans incidence notable sur la satisfaction des patients ni sur les taux de mortalité à l'hôpital ou de réadmission. Également, les auteurs n'ont observé aucun signe d'une détérioration de la santé des patients pouvant être associée à des séjours hospitaliers plus courts. Ce type d'information est important pour le déploiement d'une palette efficace de ressources en santé ainsi que pour déterminer les besoins à venir en matière de ressources humaines afin de pourvoir à ceux-ci de façon efficace.

Keywords: ACUTE CARE; HEALTH HUMAN RESOURCES PLANNING; HEALTH-CARE PRODUCTION; NURSING PLANNING; PATIENT OUTCOMES

Document Type: Research Article

Publication date: 2011-03-01

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