“护士银行”模式短期效应的实证研究

doi:10.3761/j.issn.0254-1769.2023.07.012

摘要/Abstract

摘要：

目的探究“护士银行”模式短期内对试点护理单元护理工作量、护理人力成本和护理质量的实际影响，为完善“护士银行”模式提供借鉴。方法运用倾向得分匹配和双重差分法对广州市某三级甲等医院67个护理单元2019年第2季度—2022年第1季度共3年的面板数据进行匹配和实证检验。结果 “护士银行”模式在5%的水平上显著提高了试点护理单元护理工作量水平。对护理人力成本、护理质量的影响不显著。通过平行趋势检验、反事实检验、安慰剂检验、更换匹配方式验证了实证结论的稳健性。结论 “护士银行”模式可在短期内提高护理工作量水平，解决护理人员短时性缺乏问题，为护理人力资源的科学配置和合理使用提供参考。

关键词: “护士银行”模式, 短期效应, 倾向得分匹配, 双重差分, 护理管理研究

Abstract:

Objective To study the actual effects of the nurse bank model on nursing workload，labour costs and quality of care in experiment nursing units，and to provide references for improving the nurse bank model. Methods A panel of 67 nursing units in a tertiary teaching hospital was matched and empirically tested by propensity score matching（PSM） and differences-in-differences（DID） from Q2 2019 to Q1 2022. Results Although the nurse bank model has no significant effect on nursing manpower costs and quality of care in experiment nursing units，nursing workload was significantly increased at 5% level. The robustness of the empirical findings was verified by parallel trend tests，counterfactual test，placebo tests，and changing the matching approaches. Conclusion The nurse bank model increases the nursing workload in a short term and then solves the short-term shortage of nursing staff. The findings provide a reference for nurse staffing and use of nursing human resources.

Key words: Nurse Bank Model, Short-Term Effects, Propensity Score Matching, Differences-in-Differences, Nursing Administration Research

胡鹏, 李琴, 杨媛, 黎海阳, 张成娟, 雒敏. “护士银行”模式短期效应的实证研究[J]. 中华护理杂志, 2023, 58(7): 850-856.

HU Peng, LI Qin, YANG Yuan, LI Haiyang, ZHANG Chengjuan, LUO Min. An empirical study of the short-term effects of nurse bank model[J]. Chinese Journal of Nursing, 2023, 58(7): 850-856.

图/表 8

表1 变量分组描述性统计

Table 1 Descriptive statistics of variable grouping

图1 倾向得分匹配前后核密度函数注：A为倾向得分匹配前，B为倾向得分匹配后。

Figure 1 Kernel density before and after PSM matching

表2 控制变量倾向得分匹配与平衡性检验结果

Table 2 Control variable propensity score matching and balance test results

表3 双重差分回归结果

Table 3 Regression result of differences-in-differences

图2 双重差分模型的平行趋势检验

Figure 2 Parallel trend test of DID model

表4 改变政策时间的反事实检验结果

Table 4 Counterfactual test results of changing policy time

图3 安慰剂检验注：A为估计系数核密度分布图，B为估计系数P值分布图。

Figure 3 Placebo test

表5 更换匹配方式的双重差分法估计结果

Table 5 DID estimation results of the replacement matching method

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