The Association between Organizational Market Factors and Agency Labor Utilization in U.S. Hospitals

IF 3 Q2 MANAGEMENT

Administrative Sciences Pub Date : 2024-08-27 DOI:10.3390/admsci14090192

Brad Beauvais, Rohit Pradhan, Diane Dolezel, Ramalingam Shanmugam, Dan Wood, Zo Ramamonjiarivelo

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Abstract

Objectives: To address urgent staffing shortages, hospitals increasingly rely on agency labor. Given that staffing can significantly impact hospital performance, the aim of this study was to understand the organizational and market factors associated with agency labor utilization in US hospitals. Methods: Utilizing concepts from the Resource Dependence Theory (RDT), data for the calendar year 2022 for short-term acute care in United States hospitals (n = 2756) were analyzed with logistic regression analysis. We explored total agency labor expense (operationalized as a dichotomous variable at the 75th and 90th percentiles) in the presence of numerous organizational and market independent variables. Results: The results revealed that as markets become less complex (as measured by market concentration), the level of agency labor expense increases (β: 0.843, p < 0.001), while our chosen variables related to munificence (rural location; β: −1.634, p < 0.001) and dynamism (Medicare payor mix; β: −0.025, p < 0.001) were negatively associated with an increase in total agency labor expense. Conclusions: In general, our results appear to support the tenets of the RDT. We find that increased use of agency labor in hospitals is predicated on the hospital having the financial resources and flexibility to be able to afford the higher cost of agency labor.

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美国医院的组织市场因素与机构劳动力使用之间的关系

目标：为了解决人手短缺的燃眉之急，医院越来越多地依赖中介公司的劳动力。鉴于人员配备会对医院绩效产生重大影响，本研究旨在了解与美国医院使用中介劳动力相关的组织和市场因素。研究方法：利用资源依赖理论（RDT）的概念，通过逻辑回归分析法对美国医院 2022 年的短期急症护理数据（n = 2756）进行了分析。我们探讨了在众多组织和市场自变量的影响下，机构的总人工支出（以二分变量的形式在第 75 和第 90 百分位数上操作）。结果显示结果显示，随着市场的复杂程度降低（以市场集中度为衡量标准），机构劳动力支出水平也随之增加（β：0.843，p < 0.001），而我们选择的与公益性（农村地区；β：-1.634，p < 0.001）和活力（医疗保险支付方组合；β：-0.025，p < 0.001）相关的变量与机构劳动力总支出的增加呈负相关。结论：总体而言，我们的结果似乎支持 RDT 的原则。我们发现，医院增加使用中介机构劳动力的前提是医院拥有能够负担中介机构劳动力较高成本的财务资源和灵活性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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