Equity ratios, patient dependency and nursing resource management

The allocation of nursing resources in hospitals is a major policy issue and there are controversies about whether a system based on equity ratios or one based on measurement of patient dependency is more accurate. This is the first empirical analysis of nurse patient ratios and patient dependency data on the same patient and staff cohort. The analysis was of 103,269 valid shifts of care, representing 1,998,902 nursing hours. It is expected to be of interest to all stakeholders, notably funding agencies that have established nursing policy using either of these two systems to measure and allocate nursing workloads. A statistical analysis of nursing hours and patient types was undertaken through retrospective analysis of existing administrative data provided by 22 acute care public and private hospitals in Australia, New Zealand and Thailand.The results showed that both ratios and the dependency based TrendCare system can predict a fair allocation of nursing resources to patients, however TrendCare predicts actual direct care requirements with greater accuracy than ratios for the full range of hospital and patient types and this facilitates better allocation of nursing resources.