J Korean Acad Nurs Adm.  2020 Dec;26(5):521-532. 10.11111/jkana.2020.26.5.521.

The Relationship between Average Length of Stay and Nurse Staffing in General Hospitals from 1996 to 2016

• Cho SH
• Lee JY
• Hong KJ
• Huh I

• KMID: 2512231
• DOI: http://doi.org/10.11111/jkana.2020.26.5.521

Abstract

Purpose
To analyze the effects of average length of stay (ALOS) on RN staffing.
Methods
Public data of patient surveys collected 8 times between 1996 and 2016 were analyzed. The sample included 2,408,669 discharged patients from 2,266 general hospitals. The ALOS for each hospital was computed by dividing the sum of inpatient days by the number of discharges. RN staffing was defined as the number of RNs per 100 inpatients. ALOS was transformed into base-2 logarithmic values for regression analysis.
Results
ALOS decreased from 13.3 to 9.6 days. Large hospitals in the capital region had the greatest reduction, from 15.7 to 7.4 days. RN staffing increased from 32.7 to 54.8 RNs per 100 patients. ALOS had an inverse relationship with RN staffing. Controlling for other factors, a 50% reduction in ALOS was associated with increases in RN staffing by 12.18 and 13.72 RNs per 100 inpatients in large hospitals in the capital region and elsewhere, respectively.
Conclusion
Hospitals may have to increase staffing to respond to the increased workload resulting from the shortened ALOS. It remains uncertain whether such increases in staffing were sufficient for the increased workload. Changes in ALOS should be taken into account when determining appropriate staffing.

Keyword

General hospitals; Nurses; Average length of stay; Staffing