Influence of hospital nurse staffing levels on the colorectal cancer evaluation grades, mortality, and length of stay

Abstract

Purpose: In Korea, cancer is the leading cause of death, and colorectal cancer accounts for a third of deaths caused by cancer. This study aimed to analyze the influence of hospital nurse staffing level on colorectal cancer evaluation grades, mortality rate, and the length of stay of patients who underwent surgery for colorectal cancer. Methods: Secondary data collected in 2016, 2018 from the Health Insurance Review and Assessment Service, was used to measure nurse staffing, based on the adjusted nursing grade in general units and was then categorized as adhering with or violating the Medical Service Act. The influence of the nurse staffing on colorectal cancer evaluation grades, and the mortality rate in 129 hospitals was analyzed using multivariate logistic regression and multivariate gamma regression, respectively, and its influence on length of stay was analyzed through hierarchical multiple regression. Results: Hospitals that adhered to the Medical Service Act in nurse staffing had significantly lower odds for poor colorectal cancer evaluation grades. Hospitals which nurse staffing adhered to the Medical Service Act had a significantly lower mortality rate than those that violated it (B=-0.51, p=.019), and had a significantly shorter length of stay (β=-.19, p=.034). Conclusion: Improvement of nurse staffing levels, in compliance with the Medical Service Act is crucial to provide high-quality nursing services to patients undergoing colorectal cancer surgery and to decrease the mortality rate, and shorten the hospitalization period required for surgery and recovery.