Nursing intensity: In the footsteps of John Thompson

Area of Science:

• Health Services Research
• Nursing Informatics
• Healthcare Economics

Background:

• The Nursing Minimum Data Set (NMDS) facilitates incorporating nursing data into hospital discharge abstracts.
• Current frameworks allow for comparing nursing care across institutions.
• Extending NMDS use to direct billing and reimbursement of hospital nursing care is proposed.

Purpose of the Study:

• To review existing literature and present new empirical evidence supporting direct hospital nurse billing.
• To compare two NMDS data sets: one using nursing diagnosis and another using nursing intensity for daily nursing time collection.
• To assess the explanatory power of NMDS data compared to Diagnostic Related Groups (DRG) for hospital outcomes.

Main Methods:

• Literature review on hospital nurse billing.
• Comparison of two NMDS data sets (nursing diagnosis vs. nursing intensity).
• Multivariate and logistic regression analyses comparing NMDS data to DRG and hospital outcomes from UB92 discharge abstract.

Main Results:

• Both NMDS approaches demonstrated additional explanatory power (improved R2) compared to DRG alone.
• Nursing intensity data provides a viable alternative for collecting daily nursing times.
• Empirical evidence supports the use of NMDS data for hospital nurse billing.

Conclusions:

• The findings support the use of primary nursing data, specifically nursing intensity, for direct costing, billing, and reimbursement.
• NMDS data offers valuable insights beyond traditional DRG classifications.
• Implementing NMDS for billing can lead to more accurate and equitable reimbursement for hospital nursing care.