Infections, Accidents and Nursing Overtime in a Neonatal Intensive Care Unit

Congratulations to Jean-Michel ETIENNE for his article, ‘Infections, Accidents and Nursing Overtime in a Neonatal Intensive Care Unit’ in The European Journal of Health Economics. (with Marc Beltempo, Georges Bresson, Guy Lacroix)

The paper investigates the effects of nursing overtime on nosocomial infections and medicalaccidents in a neonatal intensive care unit (NICU). The literature lacks clear evidence on this issue andwe conjecture that this may be due to empirical and methodological factors. We model the occurrences ofboth events using a sample of 3,979 neonates who represents over 84,846 observations (infant/days). Weexploit an important change in workforce arrangement that was implemented in June 2012, and whichaimed at reducing overtime hours to identify a causal impact between the latter and the two outcomesof interest. We contrast the results using a standard mixed-effects logit model with those of a semipara-metric mixed-effects logit model. Contrary to the mixed-effects logit model, the semiparametric modelunequivocally shows that both adverse events are impacted by nursing overtime as well as being highlysensitive to infant and NICU-related characteristics. Furthermore, the mixed-effects logit model is re-jected in favour of the semiparametric one.

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