Seago JA, Ash M; Academy for Health Services Research and Health Policy. Meeting.

Abstr Acad Health Serv Res Health Policy Meet. 2000; 17: UNKNOWN.

Presented by: Jean Ann Seago, Ph.D., R.N., Assistant Professor, Department of Community Health Systems, University of California, San Francisco, Box 0608, San Francisco, CA 94143-0608; Voice-415-502-6340; Fax 415-476-6042; email-hwk@itsa.ucsf.edu

Research Objective: There is a substantial literature on patient outcomes related to hospital organizational variables but it is still somewhat unsatisfactory. It is becoming clear that mortality is substantially predicted by patient characteristics, specifically age and severity of illness, although hospital characteristics and environmental factors also play a part. This study seeks to determine if there is a relationship between acute myocardial infarction (AMI) mortality rate, adjusted for patient age, gender, type of AMI, and chronic illnesses, for acute care hospitals in California, and the presence or absence of a bargaining unit for registered nurses. Study Design. The study design is observational, analytic, and cross-sectional. Data were obtained from the California Office of Statewide Health Planning and Development California Hospital Outcomes Project (CHOP). RN union status was found using web pages such as the National Labor Relations Board (NLRB) web page, from various bargaining unions, or by calling the hospitals directly. Population Studied: All acute care hospitals in CaliforniaPrincipal Findings: After accounting for wage, bed size, volume, cardiac services, RN hours, total staff hours, and number of MDs, hospitals with unionized registered nurses have between 1 and 1.5 percentage points lower risk-adjusted AMI mortality, with the average hospital having an average risk-adjusted AMI mortality of 13.8 percent. So, having an RN union RNs was related to a reduced AMI mortality between 7.2 percent (1/13.8) and 10.9 percent (1.5/13.8). Conclusions: Hospitals with unionized registered nurses have better AMI mortality rates, even after accounting for patient characteristics and other organizational characteristics.Implications for Policy, Delivery, or Practice: We are not ready to advocate that all hospital RNs form unions. However, perhaps having an RN union promotes the autonomy, collaboration, and control that Aiken and others describe as having positive influence on patient outcomes. It is clear that accounting for union status is important when trying to determine the organizational factors that influence patient outcomes. Primary Funding Source: The American Nursing Foundation

Publication Types:

• Meeting Abstracts

Keywords:

• Acute Disease
• California
• Hospital Bed Capacity
• Hospitals
• Humans
• Myocardial Infarction
• Nurses
• Salaries and Fringe Benefits
• mortality
• hsrmtgs

Other ID:

• GWHSR0001070

UI: 102272744

From Meeting Abstracts