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Does labour substitution occur in district general hospitals?
J Jones1, C Sanderson, N Black
1London School of Hygiene and Tropical Medicine.
Health Trends
|December 9, 1992
Summary
Hospital staffing levels for medical and nursing care vary significantly per patient episode, unrelated to patient complexity. High staffing in one area often correlates with high staffing in others, indicating potential resource allocation inequalities.
Area of Science:
- Healthcare Management
- Hospital Operations
- Medical Staffing
Background:
- Significant variations exist in medical and nursing staff hours allocated per inpatient episode across district general hospitals.
- These variations in healthcare resource allocation are not explained by differences in patient case-mix or severity.
Purpose of the Study:
- To investigate the extent of variation in medical and nursing staff hours per inpatient episode in general medicine.
- To determine if variations in staffing levels are attributable to case-mix, severity, or staff grading.
Main Methods:
- Survey of 31 district general hospitals to collect data on staff hours per inpatient episode.
- Analysis of data considering different grades of nursing and medical staff.
Main Results:
- A large variation in staff hours per episode was observed, not explained by case-mix or severity.
- Weighting staff by grade had minimal impact on hospital rankings or the degree of variation.
- Hospitals with high staffing in one category tended to have high staffing in others, suggesting systemic inequalities.
Conclusions:
- Evidence suggests significant inequalities in resource allocation for medical and nursing staff across hospitals.
- These inequalities may stem from historical resource allocation patterns.
- Further research on the link between staffing levels and patient care quality is recommended before policy changes.