The Transmission of Nurse Employment Spillovers and Their Impact on Inpatient Care Quality: A Dynamic Connectedness...

This study examines the intersectoral interdependencies of nurse employment, conceptualized as nurse employment spillovers, and their effects on inpatient care quality in Taiwan. It particularly addresses the critical issue that over 40% of Taiwanese nurses report unwillingness to enter or remain in the nursing profession.

The research design follows a quantitative and observational time-series methodology. A time-series dynamic connectedness network analysis was employed to assess interdependencies in nurse employment across various practice settings. Additionally, a general-to-specific modeling approach was used to examine the relationship between the transmission of nurse employment spillovers and inpatient care quality. The analysis utilized annual data from 1997 to 2023, comprising 27 observations, sourced from publicly available Taiwanese government databases that contain information on nurse employment, inpatient care quality indicator, and relevant control variables.

The analysis reveals that nurse employment in other healthcare facilities and the non-nursing labor market (hospitals, clinics, and long-term care facilities) serves as a net transmitter (receiver) of nurse employment spillovers. Notably, nurse employment inflows from non-nursing to nursing labor markets are linked to enhancements in inpatient care quality. Five distinct spillover pathways originating from clinics, other medical institutions, and non-nursing sectors into hospitals were identified as having positive effects on inpatient care quality. Furthermore, increases in nurses' regular wages are associated with a shift in employment toward hospital settings.

These findings underscore the importance of strengthening hospital nurse employment to improve inpatient care quality. Policymakers should consider salary increases as a means to attract and retain nurses in the healthcare sector, thereby mitigating shortages of nurses and enhancing care outcomes.