Nursonomics

November 5, 2016 -- The economics of nursing is complex and important. Typically, the cost of nursing service in a hospital is bundled into the room rate and not billed separately. It is not a revenue center; it does not generate income.

Thus, nursing -- in most hospitals the single largest payroll category -- is treated as a cost center. So -- as with any expense -- the conventional strategy is to minimize it. This means hiring as few nurses as possible. That's different from, say, the expense of a new CAT scanner machine. The CAT scanner generates revenue each time it's used. Nurses don't. Yet without them hospitals are useless. With too few of them, patients die.

As reported in Medscape, The More RNs, the Higher the Patient Survival:

...each additional patient per nurse on a medical-surgical unit was associated with a 5% lower odds of survival ...below-target RN staffing patterns and high patient turnover increased the risk for patient death.
So what's good for patients is bad for hospitals' bottom lines. With new mandates that tie reimbursements to outcomes, however, this is changing. The time is ripe for new economic models for nursing.

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