Nursing Utilization Review System (NURS) : rationale and issues associated with the costing of nursing services by DRG

Nursing cost variations between hospitals, by DRG, may be due to a number of different factors. This paper identifies and discusses these relative to the capture of nursing resource usage (staffing) and actual cost data. The main issues are those of terminology, cost allocation methods and the measurement of nursing resource usage. It then proceedes to discuss how these data may be processed and used as a basis for efficiency review and management decision making. It is concluded that the widespread use of standard methods for resource and cost identification by DRG will provide the most comprehensive and useful information on which to base management and policy decisions regarding nursing resource allocation. A list of questions to assist cost variance analysis is provided.