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Research Article

Hospitals With Higher Nurse Staffing Had Lower Odds Of Readmissions Penalties Than Hospitals With Lower Staffing

Affiliations
  1. Matthew D. McHugh ( [email protected] ) is an associate professor of nursing at the Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, and a senior fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania, in Philadelphia.
  2. Julie Berez is an undergraduate student at the University of Pennsylvania and a research associate at the Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania.
  3. Dylan S. Small is an associate professor of statistics in the Department of Statistics, Wharton School, University of Pennsylvania.
PUBLISHED:No Accesshttps://doi.org/10.1377/hlthaff.2013.0613

The Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals’ financial incentives with payers’ and patients’ quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses’ efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.

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