中文摘要
本文研究护士短缺对医疗生产的影响。利用新颖的高频数据，我们考察护理人员缺席对住院死亡率以及与护理服务相关的其他结局的影响。我们发现，具有学位水平资质的护士短缺对死亡率有显著的不利影响：对普通病房而言，一名受过大学学位同等水平培训的护士缺席会使患者死亡的发生比（odds）提高约10%，而资质较低的护理助理短缺则没有影响。对合格护士而言，企业（医院）特有人力资本存在回报：学位资质护士的平均医院特有经验每增加一年，患者死亡的发生比降低8%，相当于向病房增派四分之三名额外的合格护士。短缺带来的不利死亡影响尤其集中于临床严重程度相对较低而非较高的患者。影响最大的是被诊断为脓毒症（sepsis）的患者——该疾病早期发现对生存至关重要，而护士在早期发现及后续控制中发挥核心作用。
Abstract
This paper examines the effect of nurse shortages on healthcare production. Employing novel high-frequency data, we examine what effect the absence of nursing staff has on inpatient mortality and other outcomes associated with nursing care. We find significant adverse mortality impacts of shortages of nurses with degree-level qualifications: for the average ward, the absence of a nurse with university degree-equivalent level training increases the odds of a patient death by approximately 10%, while there is no effect of shortages of less qualified nursing assistants. For qualified nurses, there are returns to firm (hospital) specific human capital: increasing the average firm-specific experience among degree qualified nurses by one year is associated with an 8% reduction in the odds of a patient death, the equivalent to adding three-quarters of an extra qualified nurse to the ward. Adverse mortality impacts of shortages are particularly concentrated among patients of relatively low, rather than high, clinical severity. The largest impacts are for those diagnosed with sepsis, a condition where early detection is important for survival and where nurses have a central role in detection and subsequent control.