HR Resources Database

HR Resources Database May 2004 : 0-0

Simulating the Components of Resource Intensity Weight: A Good Proxy for Allocating Health Human Resources Across Inpatients?

Kisalaya Basu, Stéphane L. Paré and Ronald Wall

Abstract

Health Canada's Registered Nurses' (RNs) demand model for Alberta assigns full-time equivalent registered nurses (FTE RNs) by nursing function (e.g., paediatric, oncology, mental health etc.) to inpatient age-sex groupings in proportion to their expected use of hospital resources (i.e, nursing and other hospital staff time, equipment, supplies, drugs). The RIW -- a relative value assigned to each patient upon discharge - predicts the use of hospital resources on the basis of patient case-mix, severity, age, and procedures performed. This paper validates using the RIWs to assign RNs to inpatient-groupings by using a simple mathematical conceptual model and a simulation. It shows that RIW is a good predictor of nurse-use across nursing function. Differences in health human resource intensity across different nursing functions, and differences in prices of non-human elements, e.g., drugs, also does not affect the proportional relationship between total RIW and FTE of RNs within a nursing function in the absence of technological change. Thus, we find strong association between the RIW and the in-hospital requirement for nurses.
The Microsimulation Modelling and Data Analysis Division of the Applied Research and Analysis Directorate, Health Canada, has built a Health Human Resources (HHR) model to project future requirement for Registered Nurses (RNs) in Alberta [1]. In brief, the model uses the base-year relationship between the demographic/clinical characteristics of active care inpatients (i.e., age, sex, most responsible diagnosis), the relative need for nursing and other resources (case-mix and case-complexity), and the full-time equivalence (FTE) of RNs who provide such nursing care. The base-year relationship is estimated using patient data reported for each discharge and the Canadian Institute for Health Information (CIHI) Registered Nurse Database (RNDB), which is an annual registry of all RNs eligible (i.e., registered) to practice by nursing function and employment status. The sensitivity of projections of future requirements for RNs takes into account scenarios of possible changes in population need for active inpatient care and patterns of RN staffing.

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