Improved Staffing Cuts Medicare Patient Readmissions

Nurses' work environment and staffing issues affect readmissions for heart failure, MI, pneumonia

FRIDAY, Jan. 4 (HealthDay News) -- Hospital nurses with good work environments who are caring for fewer patients have significantly fewer elderly Medicare patients with heart failure, acute myocardial infarction (MI), and pneumonia who are readmitted to the hospital within the first 30 days, according to research published in the January issue of Medical Care.

Matthew D. McHugh, Ph.D., J.D., M.P.H., R.N., and Chenjuan Ma, Ph.D., R.N., of the University of Pennsylvania in Philadelphia, studied the relationship between the work environment, education, and staffing level of hospital nurses and 30-day readmissions for Medicare patients with heart failure, acute MI, and pneumonia.

The researchers found that, overall, 23.3 percent of heart failure, 19.1 percent of MI, and 17.8 percent of pneumonia cases in Medicare patients were readmitted to the hospital within 30 days. The risk of readmission for these conditions was between 6 and 9 percent higher for each additional patient assigned to a hospital nurse. Additionally, patients cared for by hospital nurses working in a good work environment had a significantly lower risk of readmission for heart failure (7 percent lower), MI (6 percent lower), and pneumonia (10 percent lower).

"Our results suggest that improving nurses' work environment and reducing nurses' workload are organization-wide reforms that could result in fewer readmissions for Medicare beneficiaries with common medical conditions," the authors write. "This is consistent with the evidence showing significant associations between the nurse work environment, staffing, and other patient outcomes."

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