First objective:
For the first objective, we used data collected from 2014 to 2020 by the Federal Statistical Office, focusing on Swiss acute care and specialised hospitals, as well as the nurses and doctors working in them. Using this de-identified data, we conducted descriptive analysis and used an advanced statistical method, mixed-effect regression analysis, to identify the key factors that influence wages for nurses and doctors.
We analysed data from 161 to 173 hospitals each year over seven years (2014–2020), including 524,263 nurses and 176,896 doctors. We found that nurses’ wages were mostly influenced by their age, the number of registered nurses, and the wages of doctors. For doctors, wages were most affected by the number of residents and medical students and the wages of nurses.
Second objective:
For the second objective, we used the same data as in the first objective, focusing on the year 2019. We also included patient data from the same period and hospitals, linking all the information using anonymized hospital identification numbers. We analyzed the data to identify patterns, presenting counts and percentages for categories and averages for numerical data. To examine the relationship between nurse and doctor wages (grouped by hospital) and 30-day patient death rates, we used a statistical method called Generalized Additive Mixed Model (GAMM). We also repeated the same analysis using data from 2018 and 2020 to check the consistency of our results.
We examined 2019 data from 1,015,995 adult hospital admissions and 94,364 healthcare workers (69,112 nurses and 25,252 doctors) across 82 acute care hospitals. In 2019, 2.3% of patients died within 30 days of admission. We found a small connection between higher doctor wages and slightly lower death rates, reducing the risk by 2%. However, no similar link was found between nurse wages and 30-day death rates.
Exploitation and dissemination of results:
The study results were regularly shared with the HONEST Stakeholder Group, which included key Swiss policymakers and stakeholders. Findings were presented at prominent events such as the Nursing Data Symposium (Lucerne, Switzerland), the AcademyHealth Annual Research Meeting (Baltimore, USA), and the Wennberg International Collaborative Research Meeting (Oslo, Norway). Dissemination within the University of Basel included presentations at the INS-spiration Meeting and the Antelope Career Camp, while broader outreach efforts featured presentations to the Sounding Board of Swiss Policymakers, the International Labour Organization, and the University of Kansas.
The results were also disseminated through the HONEST project websites to reach a wider audience.
