Hospital Nursing and 30-Day Readmissions Among Medicare Patients With Heart Failure, Acute Myocardial Infarction, and Pneumonia
Datos Bibliográficos
| ID | 9103694 |
|---|---|
| Autores | Matthew D McHugh (0000-0002-1263-0697, National Institute of Nursing Research), Chenjuan Ma (0000-0002-3792-2565, National Institute of Nursing Research) |
| Año | 2013 |
| Volumen | 51 |
| Número | 1 |
| Páginas | 52-59 |
| Fecha de publicación | 2013-01-01 |
| Peer Reviewed | Sí |
| Open Access | No |
| Tipo | ARTICLE |
| Revista | Medical Care (JOURNAL) |
| Identificadores de la revista | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Editorial | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e3182763284 |
| PMID | 23151591 |
| PMCID | PMC3593602 |
| OpenAlex | W1975738326 |
| Idioma | EN |
| Citas recibidas | 18 |
| Referencias citadas | 42 |
BACKGROUND: Provisions of the Affordable Care Act that increase hospitals' financial accountability for preventable readmissions have heightened interest in identifying system-level interventions to reduce readmissions. OBJECTIVES: To determine the relationship between hospital nursing; that is, nurse work environment, nurse staffing levels, and nurse education, and 30-day readmissions among Medicare patients with heart failure, acute myocardial infarction, and pneumonia. METHOD AND DESIGN: Analysis of linked data from California, New Jersey, and Pennsylvania that included information on the organization of hospital nursing (ie, work environment, patient-to-nurse ratios, and proportion of nurses holding a BSN degree) from a survey of nurses, as well as patient discharge data, and American Hospital Association Annual Survey data. Robust logistic regression was used to estimate the relationship between nursing factors and 30-day readmission. RESULTS: Nearly 1 quarter of heart failure index admissions [23.3% (n=39,954)], 19.1% (n=12,131) of myocardial infarction admissions, and 17.8% (n=25,169) of pneumonia admissions were readmitted within 30 days. Each additional patient per nurse in the average nurse's workload was associated with a 7% higher odds of readmission for heart failure [odds ratio (OR)=1.07; confidence interval CI, 1.05-1.09], 6% for pneumonia patients (OR=1.06; CI, 1.03-1.09), and 9% for myocardial infarction patients (OR=1.09; CI, 1.05-1.13). Care in a hospital with a good versus poor work environment was associated with odds of readmission that were 7% lower for heart failure (OR=0.93; CI, 0.89-0.97), 6% lower for myocardial infarction (OR=0.94; CI, 0.88-0.98), and 10% lower for pneumonia (OR=0.90; CI, 0.85-0.96) patients. CONCLUSIONS: Improving nurses' work environments and staffing may be effective interventions for preventing readmissions
Acute care · Confidence interval · Health care · Heart failure · Intensive care medicine · Logistic regression · Myocardial infarction · Odds · Odds ratio · Pneumonia · Workload · Cardiovascular Function and Risk Factors · Emergency Medicine · Heart Failure Treatment and Management · Internal Medicine · Medicine · Nursing · Nursing education and management
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| Obras citantes distintas | 18 |
|---|---|
| Citas por año | 1,38 |
| Intervalo de citas | 2013 - 2025 (13) |
| Velocidad de citación | recent |
| Altamente citado | No |
| Tipos de cita | Neutras: 14 |