Working Paper: NBER ID: w17474
Authors: Ann P. Bartel; Ciaran S. Phibbs; Nancy Beaulieu; Patricia Stone
Abstract: This paper contributes to the literature on the relationship between human capital and organizational performance. We use detailed longitudinal monthly data on nursing units in the Veterans Administration hospital system to identify how the human capital (general, hospital-specific and unit or team-specific) of the nursing team on the unit affects patients' outcomes. Since we use monthly, not annual, data, we are able to avoid the omitted variable bias and endogeneity bias that could result when annual data are used. Nurse staffing levels, general human capital, and unit-specific human capital have positive and significant effects on patient outcomes while the use of contract nurses, who have less specific capital than regular staff nurses, negatively impacts patient outcomes. Policies that would increase the specific human capital of the nursing staff are found to be cost-effective.
Keywords: human capital; organizational performance; healthcare; nursing; patient outcomes
JEL Codes: I11; I12; J24
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Higher nurse staffing levels (I11) | Shorter patient lengths of stay (I11) |
| Higher nurse staffing levels (I11) | Fewer complications (I19) |
| 10% reduction in nursing hours by less experienced staff (J22) | 11% decrease in length of stay (C41) |
| Additional year of average unit tenure (C41) | 13.23% reduction in length of stay (C41) |
| Presence of contract nurses (I11) | Increased length of stay (C41) |
| Presence of contract nurses (I11) | Increased complications (I12) |