Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing.
Hospitals with higher nurse staffing had lower odds of readmissions penalties than hospitals with lower staffing.
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DOI：
10.1377/hlthaff.2013.0613
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发表时间：
2013-10
期刊：
影响因子：
--
通讯作者：
Small DS
中科院分区：
文献类型：
--
作者：
McHugh MD;Berez J;Small DS
《平价医疗法案》的医院再入院减少计划（HRRP）根据医疗保险受益人中过高的再入院率对医院进行处罚。该计划的目的是减少再入院人数，同时使医院的财政激励与付款人和患者的质量目标保持一致。许多减少再入院的循证干预措施，如出院准备、护理协调和患者教育，都是以基本护理的基础为基础的。然而，人员配备不足可能会阻碍护士努力开展这些护理过程。我们估计了护士人员配置对医院在HRRP下受到惩罚的可能性的影响。与人手较少的同类医院相比，护士人数较多的医院受到处罚的几率要低25%。护理投资是减少再入院的潜在系统级干预措施，政策制定者和医院管理者在检查向美国医院患者提供的护理质量时，应该在新的监管环境中考虑这一点。
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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