Background: In Italy, Diagnosis-Related Groups (DRGs) have been adopted for hospital services reimbursement. In some Italian regions, nurse staffing allocation is purely volume-based, with different minutes/patient/day categories determined by the type of hospital ward. The Information System of Nursing Performance (SIPI) is a valid and reliable tool assessing nursing care complexity as an indicator of the actual nursing care demand. Evidence is lacking about the ability of current resource allocation methods to account for the nursing care demand. Objective: To evaluate the association between (1) DRG rates and nursing care complexity and (2) hospital ward categories of nurse staffing and nursing care complexity. Methods: All patients discharged from the medical department of an Italian hospital over a data collection period were eligible. To assess the association between nursing care complexity (SIPI) and DRGs, the distribution of the DRG rate (median and first–third quartile) was compared for cases with high or low complexity. To evaluate the association between nursing care complexity (SIPI) and nurse staffing, the frequency of high complexity within nurse staffing categories (120/180/240 min/patient/day) was compared. Because the sample was very large, methods of statistical inference were not applied, and only descriptive measures were reported. Results: 6872 hospitalizations were included. The median DRG rate for high and low complexity admissions were very similar (EUR 3536 and EUR 3285, respectively). The proportion of admissions with high complexity decreased for wards with higher staffing allocation rates. Conclusion: DRG reimbursement and the nurse staffing allocation systems were ineffective in accounting for nursing care complexity. The SIPI could help identify areas requiring more financial and staffing resources for nursing care.

Fabrizi, D., Bernasconi, D., Locatelli, G., Luciani, M., Beretta, G., Di Mauro, S., et al. (2024). How Are Diagnosis-Related Groups and Staffing Allocation Systems Associated with the Complexity of Nursing Care? An Observational Study. HEALTHCARE, 12(19) [10.3390/healthcare12191988].

How Are Diagnosis-Related Groups and Staffing Allocation Systems Associated with the Complexity of Nursing Care? An Observational Study

Fabrizi, Diletta;Bernasconi, Davide Paolo;Locatelli, Giulia;Luciani, Michela;Beretta, Giorgio;Di Mauro, Stefania;Rebora, Paola;Ausili, Davide
2024

Abstract

Background: In Italy, Diagnosis-Related Groups (DRGs) have been adopted for hospital services reimbursement. In some Italian regions, nurse staffing allocation is purely volume-based, with different minutes/patient/day categories determined by the type of hospital ward. The Information System of Nursing Performance (SIPI) is a valid and reliable tool assessing nursing care complexity as an indicator of the actual nursing care demand. Evidence is lacking about the ability of current resource allocation methods to account for the nursing care demand. Objective: To evaluate the association between (1) DRG rates and nursing care complexity and (2) hospital ward categories of nurse staffing and nursing care complexity. Methods: All patients discharged from the medical department of an Italian hospital over a data collection period were eligible. To assess the association between nursing care complexity (SIPI) and DRGs, the distribution of the DRG rate (median and first–third quartile) was compared for cases with high or low complexity. To evaluate the association between nursing care complexity (SIPI) and nurse staffing, the frequency of high complexity within nurse staffing categories (120/180/240 min/patient/day) was compared. Because the sample was very large, methods of statistical inference were not applied, and only descriptive measures were reported. Results: 6872 hospitalizations were included. The median DRG rate for high and low complexity admissions were very similar (EUR 3536 and EUR 3285, respectively). The proportion of admissions with high complexity decreased for wards with higher staffing allocation rates. Conclusion: DRG reimbursement and the nurse staffing allocation systems were ineffective in accounting for nursing care complexity. The SIPI could help identify areas requiring more financial and staffing resources for nursing care.
Articolo in rivista - Articolo scientifico
complexity of nursing care; diagnosis-related groups; nursing staff; financial system; National Health Service; nursing care; financial management
English
5-ott-2024
2024
12
19
1988
open
Fabrizi, D., Bernasconi, D., Locatelli, G., Luciani, M., Beretta, G., Di Mauro, S., et al. (2024). How Are Diagnosis-Related Groups and Staffing Allocation Systems Associated with the Complexity of Nursing Care? An Observational Study. HEALTHCARE, 12(19) [10.3390/healthcare12191988].
File in questo prodotto:
File Dimensione Formato  
Fabrizi-2024-Healthcare-VoR.pdf

accesso aperto

Descrizione: This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Tipologia di allegato: Publisher’s Version (Version of Record, VoR)
Licenza: Creative Commons
Dimensione 740.97 kB
Formato Adobe PDF
740.97 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/520079
Citazioni
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
Social impact