Term of Award

Spring 1991

Degree Name

Master of Science in Nursing

Document Type and Release Option

Thesis (restricted to Georgia Southern)

Committee Chair

Emma A. Bell

Committee Member 1

Les G. Parrish, Jr.

Committee Member 2



The purpose of this exploratory study was to examine the relationship of the cost of direct nursing care and selected variables. The variables were unit size, staff mix, nursing care delivery model, hours per patient day, and comparative cost per patient day. The theory of productivity was the framework utilized as the basis for the study.

The study utilized national multi-hospital data collected by survey by the Medicus Corporation. Reliability and validity guidelines for the collection of data were defined and evaluated by Medicus Corporation. The data was provided to the researcher by Medicus Corporation.

The population consisted of all hospitals in the United States which utilized the Medicus Productivity and Quality System. The sample (n = 463) represented medical, surgical, and medical/surgical units which participated in the Medicus National Data Book Survey of March through May, 1989.

The data were analyzed using descriptive statistics, Chi square, Kruskal-Wallis, analysis of variance by ranks, and the Scheffe test. A formula for the comparative cost per patient day was developed by the researcher. It was formulated from salary information, staff mix, and hours per patient day provided from the Medicus National Comparative Data Book Survey.

Conclusions reached were:

1. There was a relationship among staff mix, NCDM, hours per patient day and the cost per patient day.

2. A relationship between unit size and hours per patient day in the all region sample was determined. A relationship could not be proven in the region 3 between unit size and hours per patient day.

3. Unit size is a crucial variable in resource allocation.

4. There was an overall reduction in RN percentage nationally and more acutely in the South Atlantic Region.

5. There was a significant variation in the Nursing Care Delivery Model and cost.

6. The use of national data at a regional level is highly problematic.

The present study was a partial replication of a study by Glandon, Colbert, and Thomasma (1989) which utilized data from the Medicus National Data Book collected during March through May, 1987. Findings from this study supported those previously reported by Glandon et al. (1989).

The major contributions to nursing included identifying a formula for quantifying cost of direct nursing care. This formula can be utilized by nursing administrators and managers to understand the factors affecting cost. It can provide a basis for budget formulation.

Implications of the study include: (1) identification of a need to develop nursing care delivery models which provide consistent cost and quality results; (2) confirmation that the use of the Medicus multi-hospital data base allows for comparison of nursing cost across hospital settings; and (3) information provided by analysis of Medicus survey data provides nursing administrators and managers a monitoring tool to track resource utilization on a unit base.


To obtain a full copy of this work, please visit the campus of Georgia Southern University or request a copy via your institution's Interlibrary Loan (ILL) department. Authors and copyright holders, learn how you can make your work openly accessible online.

Files over 10MB may be slow to open. For best results, right-click and select "Save as..."