hospital staffing and public health

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rachmoninov3

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Dear Public health peoples,

I was wondering if nurse to patient ratios (6:1 for med surg, 4:1 PCU, 2:1 ICU etc) would at all be considered a public health issue. My analogy would be that public health regulates food service businesses and keeps the public safe from food born illnesses. I do not see why it is also not public health's responsibility to protect the public from hospital corporations who may choose to cut staffing in order to meet budget while compromising patient care (this has been well documented in medical journals).

I am but a young family doctor and would appreciate responses either disagreeing with my anaology (and why) or letting me know if there is already a push in this direction and how I might be able to help.

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Yes, there are absolutely fields of "health services research" and/or health policy that could look into these issues. There are many public health schools - most commonly ones at schools that also have large affiliated teaching hospitals, but not necessarily - working in this type of area.

In terms of how individuals can help: I think it may also depend on what level you would want to intervene. For example if you want to effect change within a single hospital then perhaps health administration (MHA), or operations research, would be more appropriate to work with budgets and management. If interested in broader research or health policy change, research in health services might be appropriate, even bringing in an economist to do some cost-effectiveness studies.

I don't know how feasible it is to move the needle on the wider, underlying issue of private hospital corporations implementing cost-cutting measures, but I would point out that management, budget, and doctor staffing issues also affect publicly run health service providers. The VA is a recent example that springs to mind. There are more interconnected fundamental problems at hand here like the rising costs of healthcare in general, so one would also have to think about how reducing the patient : doctor ratio would affect the costs to those patients, the costs of insurance, to taxpayers, etc.

mb
 
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