Volume 51 | Number 6 | December 2016

Abstract List

Grant R. Martsolf Ph.D., M.P.H., R.N., Teresa B. Gibson Ph.D., Richele Benevent M.S., H. Joanna Jiang Ph.D., Carol Stocks Ph.D., R.N., Emily D. Ehrlich M.P.H., Ryan Kandrack B.S., David I. Auerbach Ph.D.


To study the association between hospital nurse staffing and Hospital Consumer Assessment of Healthcare Providers and Systems () scores.

Data Sources

State hospital financial and utilization reports, Healthcare Cost and Utilization Project State Inpatient Databases, survey, and American Hospital Association Annual Survey of Hospitals.

Study Design

Retrospective study using cross‐sectional and longitudinal models to estimate the effect of nurse staffing levels and skill mix on seven measures.

Data Collection/Extraction Methods

Hospital‐level data measuring nurse staffing, patient experience, and hospital characteristics from 2009 to 2011 for 341 hospitals (977 hospital years) in California, Maryland, and Nevada.

Principal Findings

Nurse staffing level (i.e., number of licensed practical nurses and registered nurses per 1,000 inpatient days) was significantly and positively associated with all seven measures in cross‐sectional models and three of seven measures in longitudinal models. Nursing skill mix (i.e., percentage of all staff who are registered nurses) was significantly and negatively associated with scores on one measure in cross‐sectional models and none in longitudinal models.


After controlling for unobserved hospital characteristics, the positive influences of increased nurse staffing levels and skill mix were relatively small in size and limited to a few measures of patients' inpatient experience.