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Original Article
Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients
Yunmi Kim1, Sung-Hyun Cho2, Kyung Ja June3, Soon Ae Shin4, Jiyun Kim5
Journal of Korean Academy of Nursing 2012;42(5):719-729.
DOI: https://doi.org/10.4040/jkan.2012.42.5.719
Published online: October 12, 2012

1Department of Nursing, Eulji University, Seongnam, Korea

2College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

3Department of Nursing, Soonchunhyang University, Cheonan, Korea

4Department of Health Promotion & Management, National Health Insurance Corporation, Seoul, Korea

5Department of Nursing, Gachon University, Seongnam, Korea

1Department of Nursing, Eulji University, Seongnam, Korea

2College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

3Department of Nursing, Soonchunhyang University, Cheonan, Korea

4Department of Health Promotion & Management, National Health Insurance Corporation, Seoul, Korea

5Department of Nursing, Gachon University, Seongnam, Korea

Address reprint requests to : Kim, Jiyun Department of Nursing, Gachon University, 1342 Seongnamdaero, Sujeong-gu, Seongnam 461-701, Korea. Tel : +82-31-750-8822 Fax: +82-31-750-8859 E-mail: jkim@gachon.ac.kr
• Received: February 6, 2012   • Revised: February 22, 2012   • Accepted: September 25, 2012

Copyright © 2012 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance.
  • Methods
    Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes.
  • Results
    An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)= 2.99, 95% CI (confidence interval)= 1.94-4.60], those with Grades 4-5 (OR= 1.78, 95% CI= 1.24-2.57) and those with Grades 2-3 (OR= 1.57, 95% CI= 1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis.
  • Conclusion
    Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.
  • Keywords: Personnel staffing; Nursing administration research; Outcomes research
Table 1.
Characteristics of Hospitals
Variables Categories Hospital (n=182) Patients (n=111,491)
n (%) or M±SD n (%) or M±SD
Type Hospital 9 (5.0) 1,137 (1.0)
General hospital 129 (70.9) 36,972 (33.2)
Tertiary hospital 44 (24.2) 73,382 (65.8)
Ownership Medical cooperation 95 (52.2) 38,829 (34.8)
Educational foundation 57 (31.3) 47,771 (42.9)
Public 30 (16.5) 24,891 (22.3)
Location Small city 82 (45.1) 35,636 (32.0)
Metropolitan 100 (54.9) 75,855 (68.0)
Size (number of beds) 508.6±312.6 −
50-299 45 (24.7) 6,201 (5.6)
300-499 60 (33.0) 12,938 (11.6)
500-699 37 (20.3) 20,722 (18.6)
700-999 35 (19.2) 44,497 (39.9)
≥1000 5 (2.8) 27,133 (24.3)
Physician staffing 27.1±16.8 −
(number/100 beds) <10 28 (15.4) 3,071 (2.8)
10-19 55 (30.2) 8,137 (7.3)
20-29 24 (13.2) 8,373 (7.5)
30-39 29 (15.9) 23,552 (21.1)
40-49 32 (17.6) 41,980 (37.7)
≥50 14 (7.7) 26,378 (23.7)
Adjusted nurse staffing grade Grade 7 5 (2.8) 764 (0.7)
Grade 6 22 (12.1) 1,766 (1.6)
Grade 5 17 (9.3) 1,868 (1.7)
Grade 4 22 (12.1) 4,280 (3.8)
Grade 3 58 (31.9) 25,423 (22.8)
Grade 2 41 (22.5) 34,576 (31.0)
Grade 1 15 (8.2) 26,807 (24.0)
Grade 0 2 (1.1) 16,007 (14.4)
Table 2.
Characteristics of Patients (N=111,491)
Variables Categories n (%)
Age (year) 20-29 2,454 (2.2)
30-39 5,620 (5.0)
40-49 14,903 (13.4)
50-59 26,706 (24.0)
60-69 33,282 (29.9)
70-85 28,526 (25.6)
Gender Female 40,857 (36.7)
Health insurance type Self employees-dependants 11,952 (10.7)
Self employees-insured 28,458 (25.5)
Industrial workers-dependants 49,408 (44.3)
Industrial workers-insured 21,673 (19.4)
Income 1st quartile 17,972 (16.1)
2nd quartile 19,015 (17.1)
3rd quartile 28,360 (25.4)
4th quartile 46,144 (41.4)
Past history* Pneumonia 1,110 (1.0)
Sepsis 1,053 (0.9)
Urinary tract Infection 2,041 (1.8)
Admission route Emergency room 33,174 (29.8)
Outpatient department 78,317 (70.2)
Surgery Major craniotomy except for trauma 13,142 (11.8)
Other craniotomy except for trauma 3,177 (2.9)
Craniotomy for trauma Cardiac valve procedure with/without cardiac catheter 2,544 2,154 (2.3) (1.9)
Cardiac valve procedure with/without cardiac catheter Coronary bypass with/without cardiac catheter 2,154 2,138 (1.9) (1.9)
Coronary bypass with/without cardiac catheter 2,138 (1.9)
Major reconstructive vascular procedure 1,184 (1.1)
Percutaneous cardiovascular procedure 46,331 (41.6)
Amputation for circulatory system disorders 1,068 (1.0)
Rectal resection with/without complication and comorbidity 5,494 (4.9)
Major small and large bowel procedure 10,727 (9.6)
Stomach, esophageal and duodenal procedure 17,503 (15.7)
Pancreas, liver and shunt procedure 6,029 (5.4)
Severity 3-severe complication and comorbidity 2,152 (1.9)
2-moderate complication and comorbidity 14,868 (13.3)
1-minor complication and comorbidity 30,413 (27.3)
0-No complication and comorbidity 64,058 (57.5)

*Existence of past history is not mutually exclusive. To detect past history of pneumonia, sepsis and unrinary tract infection, related health problems, such as respiratory diseases, inflammatory diseases, and unrologic diseases, patients' claims were tracked.

Table 3.
In-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection by Nurse Staffing Level (N=111,491)
Variables Staffing grade Death Pneumonia Sepsis Urinary tract infection
Died Survived χ2 (p) Experienced Not experienced χ2 (p) Experienced Not experienced χ2 (p) Experienced Not experienced χ2 (p)
n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
Total 6-7 180 (7.1) 2,350 (92.9) 286.97 83 (3.3) 2,447 (96.7) 69.40 53 (2.1) 2,477 (97.9) 35.28 155 (6.1) 2,375 (93.9) '118.59
4-5 178 (2.9) 5,970 (97.1) (<.001) 126 (2.0) 6,022 (98.0) (<.001) 68 (1.1) 6,080 (98.9) (<.001) 166 (2.7) 5,982 (97.3) (<.001)
2-3 1,768 (3.0) 58,231 (97.0) 732 (1.2) 59,267 (98.8) 609 (1.0) 59,390 (99.0) 1,329 (2.2) 5,8670 (97.8)
0-1 485 (1.1) 42,329 (98.9) 169 (0.4) 42,645 (99.6) 323 (0.8) 42,491 (99.2) 391 (0.9) 42,423 (99.1)
Tertiary 2-3 953 (2.8) 33,170 (97.2) 283.43 392 (1.2) 33,731 (98.8) 156.55 295 (0.9) 33,828 (99.1) 0.59 623 (1.8) 33,500 (98.2) 140.82
   hospital 0-1 431 (1.1) 38,828 (98.9) (<.001) 142 (0.4) 39,117 (98.6) (<.001) 319 (0.8) 38,940 (99.2) (.441) 327 (0.8) 38,932 (99.2) (<.001)
Hospital 6-7 180 (7.1) 2,350 (92.9) 158.66 83 (3.3) 2,447 (96.7) 85.43 53 (2.1) 2,477 (97.9) 54.46 155 (6.1) 2,375 (93.9) 113.61
& 4-5 178 (2.9) 5,970 (97.1) (<.001) 126 (2.1) 6,022 (97.9) (<.001) 68 (1.1) 6,080 (98.9) (<.001) 166 (2.7) 5,982 (97.3) (<.001)
general 2-3 815 (3.2) 25,061 (96.9) 340 (1.3) 25,536 (98.7) 314 (1.2) 25,562 (98.8) 706 (2.7) 25,170 (97.3)
   hospital 0-1 54 (1.5) 3,501 (98.5) 27 (0.8) 3,528 (99.2) 4 (0.1) 3,551 (99.9) 64 (1.8) 3,491 (98.2)
Table 4.
GEE Logistic Regression on Patient Outcome by Nurse Staffing Level (N=111,491)
Variables Categories Death Pneumonia Sepsis Urinary Tract Infection
OR p 95% CI OR p 95% CI OR p 95% CI OR p 95% CI
Age (year) 1.03 <.001 1.02-1.03 1.03 <.001 1.02-1.03 1.01 .023 1.00-1.02 1.02 <.001 1.02-1.03
Men (vs. women) 1.22 .001 1.09-1.37 1.56 <.001 1.32-1.84 1.22 .027 1.02-1.45 0.69 <.001 0.59-0.80
Severity (vs. 0-No CC) 3-severe CC 3.42 <.001 2.19-5.36 7.32 <.001 4.07-13.17 14.77 <.001 9.13-23.87 4.45 <.001 2.50-7.89
2-moderate CC 3.95 <.001 3.21-4.85 9.25 <.001 6.97-12.26 15.22 <.001 10.62-21.82 3.73 <.001 2.93-4.75
1-minor CC 2.55 <.001 2.16-3.02 6.54 <.001 5.15-8.30 8.06 <.001 5.71-11.37 2.53 <.001 2.14-2.99
Past history (vs. No) − − − 1.13 .097 0.98-1.30 1.46 .004 1.13-1.89 1.65 <.001 1.40-1.94
Admission route ER (vs. OPD) 6.63 <.001 5.69-7.71 3.43 <.001 2.78-4.23 3.99 <.001 2.92-5.46 2.45 <.001 2.09-2.87
Health insurance Self employees-dependants 2.64 <.001 2.19-3.18 1.95 <.001 1.40-2.72 1.34 .085 0.96-1.86 1.17 .155 0.94-1.47
   type Self employees-insured 1.28 .004 1.08-1.52 1.40 .005 1.11-1.77 1.07 .598 0.83-1.39 1.04 .709 0.85-1.27
   (vs. Industrial workers-insured) Industrial workers-dependants 1.61 <.001 1.38-1.88 1.38 .018 1.06-1.81 1.24 .077 0.98-1.57 1.01 .918 0.83-1.23
Income 1st quartile 1.34 <.001 1.17-1.54 1.17 .137 0.95-1.43 1.04 .702 0.84-1.30 0.93 .348 0.80-1.08
   (vs.4th Quartile) 2nd quartile 1.19 .005 1.05-1.34 1.20 .053 1.00-1.45 1.09 .305 0.93-1.27 1.11 .203 0.95-1.30
3rd quartile 1.18 .004 1.05-1.32 1.07 .416 0.91-1.27 1.01 .925 0.88-1.15 1.05 .476 0.91-1.22
Type Hospital 1.28 .474 0.65-2.50 2.54 .141 0.73-8.82 1.18 .829 0.26-5.33 5.74 .033 1.15-28.55
   (vs. Tertiary hospital) General hospital 1.06 .586 0.86-1.30 0.92 .689 0.60-1.41 1.68 .094 0.91-3.10 1.03 .957 0.41-2.56
Ownership (vs. Public) Medical corporation 1.02 .886 0.79-1.32 0.60 .008 0.41-0.88 0.91 .738 0.51-1.61 1.01 .974 0.47-2.20
Educational foundation 1.27 .023 1.03-1.55 0.67 .061 0.44-1.02 0.84 .571 0.46-1.54 1.29 .588 0.51-3.28
Small city (vs. Metropolitan) 1.07 .886 0.93-1.23 0.93 .675 0.64-1.33 0.99 .941 0.68-1.44 1.22 .475 0.71-2.11
Physician staffing 0.81 .539 0.42-1.57 0.27 .087 0.06-1.21 13.14 .051 0.99-174.81 1 0.15 .041 0.03-0.92
Adjusted nurse staffing grade 6-7 2.99 <.001 1.94-4.60 2.79 .010 1.27-6.10 3.22 .010 1.33-7.82 1.68 .298 0.63-4.48
   (vs. 0-1) 4-5 1.78 .002 1.24-2.57 2.25 .070 0.94-5.44 1.86 .086 0.92-3.78 1.07 .884 0.43-2.66
2-3 1.57 <.001 1.25-1.98 1.73 .012 1.13-2.64 1.20 .462 0.74-1.92 1.34 .465 0.61-2.91

The results of surgery is not shown in the table; OR=Odds ratio; CI=Confidence Interval; CC=Complication and comorbidity; OPD=Outpatient department.

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        Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients
        J Korean Acad Nurs. 2012;42(5):719-729.   Published online October 12, 2012
        DOI: https://doi.org/10.4040/jkan.2012.42.5.719
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      Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients
      Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients
      Variables Categories Hospital (n=182) Patients (n=111,491)
      n (%) or M±SD n (%) or M±SD
      Type Hospital 9 (5.0) 1,137 (1.0)
      General hospital 129 (70.9) 36,972 (33.2)
      Tertiary hospital 44 (24.2) 73,382 (65.8)
      Ownership Medical cooperation 95 (52.2) 38,829 (34.8)
      Educational foundation 57 (31.3) 47,771 (42.9)
      Public 30 (16.5) 24,891 (22.3)
      Location Small city 82 (45.1) 35,636 (32.0)
      Metropolitan 100 (54.9) 75,855 (68.0)
      Size (number of beds) 508.6±312.6 −
      50-299 45 (24.7) 6,201 (5.6)
      300-499 60 (33.0) 12,938 (11.6)
      500-699 37 (20.3) 20,722 (18.6)
      700-999 35 (19.2) 44,497 (39.9)
      ≥1000 5 (2.8) 27,133 (24.3)
      Physician staffing 27.1±16.8 −
      (number/100 beds) <10 28 (15.4) 3,071 (2.8)
      10-19 55 (30.2) 8,137 (7.3)
      20-29 24 (13.2) 8,373 (7.5)
      30-39 29 (15.9) 23,552 (21.1)
      40-49 32 (17.6) 41,980 (37.7)
      ≥50 14 (7.7) 26,378 (23.7)
      Adjusted nurse staffing grade Grade 7 5 (2.8) 764 (0.7)
      Grade 6 22 (12.1) 1,766 (1.6)
      Grade 5 17 (9.3) 1,868 (1.7)
      Grade 4 22 (12.1) 4,280 (3.8)
      Grade 3 58 (31.9) 25,423 (22.8)
      Grade 2 41 (22.5) 34,576 (31.0)
      Grade 1 15 (8.2) 26,807 (24.0)
      Grade 0 2 (1.1) 16,007 (14.4)
      Variables Categories n (%)
      Age (year) 20-29 2,454 (2.2)
      30-39 5,620 (5.0)
      40-49 14,903 (13.4)
      50-59 26,706 (24.0)
      60-69 33,282 (29.9)
      70-85 28,526 (25.6)
      Gender Female 40,857 (36.7)
      Health insurance type Self employees-dependants 11,952 (10.7)
      Self employees-insured 28,458 (25.5)
      Industrial workers-dependants 49,408 (44.3)
      Industrial workers-insured 21,673 (19.4)
      Income 1st quartile 17,972 (16.1)
      2nd quartile 19,015 (17.1)
      3rd quartile 28,360 (25.4)
      4th quartile 46,144 (41.4)
      Past history* Pneumonia 1,110 (1.0)
      Sepsis 1,053 (0.9)
      Urinary tract Infection 2,041 (1.8)
      Admission route Emergency room 33,174 (29.8)
      Outpatient department 78,317 (70.2)
      Surgery Major craniotomy except for trauma 13,142 (11.8)
      Other craniotomy except for trauma 3,177 (2.9)
      Craniotomy for trauma Cardiac valve procedure with/without cardiac catheter 2,544 2,154 (2.3) (1.9)
      Cardiac valve procedure with/without cardiac catheter Coronary bypass with/without cardiac catheter 2,154 2,138 (1.9) (1.9)
      Coronary bypass with/without cardiac catheter 2,138 (1.9)
      Major reconstructive vascular procedure 1,184 (1.1)
      Percutaneous cardiovascular procedure 46,331 (41.6)
      Amputation for circulatory system disorders 1,068 (1.0)
      Rectal resection with/without complication and comorbidity 5,494 (4.9)
      Major small and large bowel procedure 10,727 (9.6)
      Stomach, esophageal and duodenal procedure 17,503 (15.7)
      Pancreas, liver and shunt procedure 6,029 (5.4)
      Severity 3-severe complication and comorbidity 2,152 (1.9)
      2-moderate complication and comorbidity 14,868 (13.3)
      1-minor complication and comorbidity 30,413 (27.3)
      0-No complication and comorbidity 64,058 (57.5)
      Variables Staffing grade Death Pneumonia Sepsis Urinary tract infection
      Died Survived χ2 (p) Experienced Not experienced χ2 (p) Experienced Not experienced χ2 (p) Experienced Not experienced χ2 (p)
      n (%) n (%) n (%) n (%) n (%) n (%) n (%) n (%)
      Total 6-7 180 (7.1) 2,350 (92.9) 286.97 83 (3.3) 2,447 (96.7) 69.40 53 (2.1) 2,477 (97.9) 35.28 155 (6.1) 2,375 (93.9) '118.59
      4-5 178 (2.9) 5,970 (97.1) (<.001) 126 (2.0) 6,022 (98.0) (<.001) 68 (1.1) 6,080 (98.9) (<.001) 166 (2.7) 5,982 (97.3) (<.001)
      2-3 1,768 (3.0) 58,231 (97.0) 732 (1.2) 59,267 (98.8) 609 (1.0) 59,390 (99.0) 1,329 (2.2) 5,8670 (97.8)
      0-1 485 (1.1) 42,329 (98.9) 169 (0.4) 42,645 (99.6) 323 (0.8) 42,491 (99.2) 391 (0.9) 42,423 (99.1)
      Tertiary 2-3 953 (2.8) 33,170 (97.2) 283.43 392 (1.2) 33,731 (98.8) 156.55 295 (0.9) 33,828 (99.1) 0.59 623 (1.8) 33,500 (98.2) 140.82
         hospital 0-1 431 (1.1) 38,828 (98.9) (<.001) 142 (0.4) 39,117 (98.6) (<.001) 319 (0.8) 38,940 (99.2) (.441) 327 (0.8) 38,932 (99.2) (<.001)
      Hospital 6-7 180 (7.1) 2,350 (92.9) 158.66 83 (3.3) 2,447 (96.7) 85.43 53 (2.1) 2,477 (97.9) 54.46 155 (6.1) 2,375 (93.9) 113.61
      & 4-5 178 (2.9) 5,970 (97.1) (<.001) 126 (2.1) 6,022 (97.9) (<.001) 68 (1.1) 6,080 (98.9) (<.001) 166 (2.7) 5,982 (97.3) (<.001)
      general 2-3 815 (3.2) 25,061 (96.9) 340 (1.3) 25,536 (98.7) 314 (1.2) 25,562 (98.8) 706 (2.7) 25,170 (97.3)
         hospital 0-1 54 (1.5) 3,501 (98.5) 27 (0.8) 3,528 (99.2) 4 (0.1) 3,551 (99.9) 64 (1.8) 3,491 (98.2)
      Variables Categories Death Pneumonia Sepsis Urinary Tract Infection
      OR p 95% CI OR p 95% CI OR p 95% CI OR p 95% CI
      Age (year) 1.03 <.001 1.02-1.03 1.03 <.001 1.02-1.03 1.01 .023 1.00-1.02 1.02 <.001 1.02-1.03
      Men (vs. women) 1.22 .001 1.09-1.37 1.56 <.001 1.32-1.84 1.22 .027 1.02-1.45 0.69 <.001 0.59-0.80
      Severity (vs. 0-No CC) 3-severe CC 3.42 <.001 2.19-5.36 7.32 <.001 4.07-13.17 14.77 <.001 9.13-23.87 4.45 <.001 2.50-7.89
      2-moderate CC 3.95 <.001 3.21-4.85 9.25 <.001 6.97-12.26 15.22 <.001 10.62-21.82 3.73 <.001 2.93-4.75
      1-minor CC 2.55 <.001 2.16-3.02 6.54 <.001 5.15-8.30 8.06 <.001 5.71-11.37 2.53 <.001 2.14-2.99
      Past history (vs. No) − − − 1.13 .097 0.98-1.30 1.46 .004 1.13-1.89 1.65 <.001 1.40-1.94
      Admission route ER (vs. OPD) 6.63 <.001 5.69-7.71 3.43 <.001 2.78-4.23 3.99 <.001 2.92-5.46 2.45 <.001 2.09-2.87
      Health insurance Self employees-dependants 2.64 <.001 2.19-3.18 1.95 <.001 1.40-2.72 1.34 .085 0.96-1.86 1.17 .155 0.94-1.47
         type Self employees-insured 1.28 .004 1.08-1.52 1.40 .005 1.11-1.77 1.07 .598 0.83-1.39 1.04 .709 0.85-1.27
         (vs. Industrial workers-insured) Industrial workers-dependants 1.61 <.001 1.38-1.88 1.38 .018 1.06-1.81 1.24 .077 0.98-1.57 1.01 .918 0.83-1.23
      Income 1st quartile 1.34 <.001 1.17-1.54 1.17 .137 0.95-1.43 1.04 .702 0.84-1.30 0.93 .348 0.80-1.08
         (vs.4th Quartile) 2nd quartile 1.19 .005 1.05-1.34 1.20 .053 1.00-1.45 1.09 .305 0.93-1.27 1.11 .203 0.95-1.30
      3rd quartile 1.18 .004 1.05-1.32 1.07 .416 0.91-1.27 1.01 .925 0.88-1.15 1.05 .476 0.91-1.22
      Type Hospital 1.28 .474 0.65-2.50 2.54 .141 0.73-8.82 1.18 .829 0.26-5.33 5.74 .033 1.15-28.55
         (vs. Tertiary hospital) General hospital 1.06 .586 0.86-1.30 0.92 .689 0.60-1.41 1.68 .094 0.91-3.10 1.03 .957 0.41-2.56
      Ownership (vs. Public) Medical corporation 1.02 .886 0.79-1.32 0.60 .008 0.41-0.88 0.91 .738 0.51-1.61 1.01 .974 0.47-2.20
      Educational foundation 1.27 .023 1.03-1.55 0.67 .061 0.44-1.02 0.84 .571 0.46-1.54 1.29 .588 0.51-3.28
      Small city (vs. Metropolitan) 1.07 .886 0.93-1.23 0.93 .675 0.64-1.33 0.99 .941 0.68-1.44 1.22 .475 0.71-2.11
      Physician staffing 0.81 .539 0.42-1.57 0.27 .087 0.06-1.21 13.14 .051 0.99-174.81 1 0.15 .041 0.03-0.92
      Adjusted nurse staffing grade 6-7 2.99 <.001 1.94-4.60 2.79 .010 1.27-6.10 3.22 .010 1.33-7.82 1.68 .298 0.63-4.48
         (vs. 0-1) 4-5 1.78 .002 1.24-2.57 2.25 .070 0.94-5.44 1.86 .086 0.92-3.78 1.07 .884 0.43-2.66
      2-3 1.57 <.001 1.25-1.98 1.73 .012 1.13-2.64 1.20 .462 0.74-1.92 1.34 .465 0.61-2.91
      Table 1. Characteristics of Hospitals

      Table 2. Characteristics of Patients (N=111,491)

      *Existence of past history is not mutually exclusive. To detect past history of pneumonia, sepsis and unrinary tract infection, related health problems, such as respiratory diseases, inflammatory diseases, and unrologic diseases, patients' claims were tracked.

      Table 3. In-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection by Nurse Staffing Level (N=111,491)

      Table 4. GEE Logistic Regression on Patient Outcome by Nurse Staffing Level (N=111,491)

      The results of surgery is not shown in the table; OR=Odds ratio; CI=Confidence Interval; CC=Complication and comorbidity; OPD=Outpatient department.

      Table 1.

      Table 2.

      Table 3.

      Table 4.

      J Korean Acad Nurs : Journal of Korean Academy of Nursing
      © Korean Society of Nursing Science.
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