Nursing shortages and patient outcomes
File(s)
Published version
Author(s)
Kelly, Elaine
Propper, Carol
Zaranko, Ben
Type
Journal Article
Abstract
This paper examines the effect of nurse shortages on healthcare production. Employing novel high-frequency data, we examine what effect the absence of nursing staff has on inpatient mortality and other outcomes associated with nursing care. We find significant adverse mortality impacts of shortages of nurses with degree-level qualifications: for the average ward, the absence of a nurse with university degree-equivalent level training increases the odds of a patient death by approximately 10%, while there is no effect of shortages of less qualified nursing assistants. For qualified nurses, there are returns to firm (hospital) specific human capital: increasing the average firm-specific experience among degree qualified nurses by one year is associated with an 8% reduction in the odds of a patient death, the equivalent to adding three-quarters of an extra qualified nurse to the ward. Adverse mortality impacts of shortages are particularly concentrated among patients of relatively low, rather than high, clinical severity. The largest impacts are for those diagnosed with sepsis, a condition where early detection is important for survival and where nurses have a central role in detection and subsequent control.
Date Issued
2026-01-01
Date Acceptance
2025-11-17
Citation
Journal of Health Economics, 2026, 105
ISSN
0167-6296
Publisher
Elsevier
Journal / Book Title
Journal of Health Economics
Volume
105
Copyright Statement
© 2025 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Publication Status
Published
Article Number
103082
Date Publish Online
2025-11-21