Provisions of the Affordable Care Act that increase hospitals’ financial accountability for preventable re-admissions have heightened interest in identifying system-level interventions to reduce re-admissions. In a previous study, nearly 1 quarter of heart failure admissions, 19.1% of myocardial infarction admissions, and 17.8% 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, 6% for pneumonia, and 9% for myocardial infarction patients. Care in a hospital with a good versus poor work environment was associated with odds of readmission that were 7% lower for heart failure, 6% lower for myocardial infarction, and 10% lower for pneumonia patients. Therefore, improving nurses’ work environments and staffing may be effective interventions for preventing re-admissions.

Medical Care: January 2013 - Volume 51 - Issue 1 - p 52–59
doi: 10.1097/MLR.0b013e3182763284

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