We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Quality and Cost Analysis of Nurse Staffing, Discharge Preparation, and Postdischarge Utilization.
- Authors
Weiss, Marianne E.; Yakusheva, Olga; Bobay, Kathleen L.
- Abstract
Objectives. To determine the impact of unit-level nurse staffing on quality of discharge teaching, patient perception of discharge readiness, and postdischarge readmission and emergency department (ED) visits, and cost-benefit of adjustments to unit nurse staffing. Data Sources. Patient questionnaires, electronic medical records, and administrative data for 1,892 medical-surgical patients from 16 nursing units within four acute care hospitals between January and July 2008. Design. Nested panel data with hospital and unit-level fixed effects and patient and unit-level control variables. Data Collection/Extraction. Registered nurse (RN) staffing was recorded monthly in hours-per-patient-day. Patient questionnaires were completed before discharge. Thirty-day readmission and ED use with reimbursement data were obtained by cross-hospital electronic searches. Principal Findings. Higher RN nonovertime staffing decreased odds of readmission (OR=0.56); higher RN overtime staffing increased odds of ED visit (OR=1.70). RN nonovertime staffing reduced ED visits indirectly, via a sequential path through discharge teaching quality and discharge readiness. Cost analysis projected total savings from 1 SD increase in RN nonovertime staffing and decrease in RN overtime of U.S.$11.64 million and U.S.$544,000 annually for the 16 study units. Conclusions. Postdischarge utilization costs could potentially be reduced by investment in nursing care hours to better prepare patients before hospital discharge.
- Subjects
COST analysis; HOSPITAL admission &; discharge; ELECTRONIC health records; INTENSIVE care nursing; EFFECTIVE teaching; UTILIZATION of hospital emergency service
- Publication
Health Services Research, 2011, Vol 46, Issue 5, p1473
- ISSN
0017-9124
- Publication type
Article
- DOI
10.1111/j.1475-6773.2011.01267.x