KMID : 1004620220280010001
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Clinical Nursing Research 2022 Volume.28 No. 1 p.1 ~ p.12
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Effects of Nurse Staffing Level on In-hospital Mortality and 30-day Mortality after Admission using Korean National Health Insurance Data
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Kim Yun-Mi
Lee Kyoung-A Kim Hyun-Young
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Abstract
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Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data.
Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on thebed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x2 test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission.
Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00).
Conclusion: To reduce the patient mortality, it is necessary to ensure asufficient number of nurses by improving the nursing fee system according to the nurse staffing level.
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KEYWORD
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Hospital Mortality, Nurses, Personnel Staffing and Scheduling, Intensive Care Units
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