Higher quality nursing work environments were associated with a greater reduction in the odds of 7-, 30-, and 90-day readmissions for older Hispanic surgical patients than non-Hispanic White patients.
Cross-Sectional (n=732,035)
Yes
Does a higher quality nurse work environment reduce hospital readmissions in older Hispanic surgical patients?
System-level investments in the nurse work environment may reduce hospital readmission disparities for older Hispanic surgical patients.
BACKGROUND: Readmissions following hospitalization for common surgical procedures are prevalent among older adults and are disproportionally experienced by Hispanic patients. One potential explanation for these disparities is that Hispanic patients may receive care in hospitals with lower-quality nursing care. OBJECTIVES: The objective of this study was to evaluate the relationship between the hospital-level work environment of nurses and hospital readmissions among older Hispanic patients. METHODS: Using linked data sources from 2014 to 2016, we conducted a cross-sectional analysis of 522 hospitals and 732,035 general, orthopedic, and vascular surgical patients (80,978 Hispanic patients and 651,057 non-Hispanic White patients) in four states. Multivariable logistic regression models were employed to determine the relationship between the work environment and older Hispanic patient readmissions at multiple time periods (7, 30, and 90 days). RESULTS: In final adjusted models that included an interaction between work environment and ethnicity, an increase in the quality of the work environment resulted in a decrease in the odds of readmission that was greater for older Hispanic surgical patients at all time periods. Specifically, an increase in three of the five work environment subscales (Nurse Participation in Hospital Affairs, Nursing Foundations for Quality of Care, and Staffing and Resource Adequacy) was associated with a reduction in the odds of readmission that was greater for Hispanic patients than their non-Hispanic White counterparts. DISCUSSION: System-level investments in the work environment may reduce Hispanic patient readmission disparities. This study's findings may be used to inform the development of targeted interventions to prevent hospital readmissions for Hispanic patients.
Daus et al. (Tue,) conducted a cross-sectional in Surgical patient readmissions (n=732,035). Hospital-level work environment of nurses vs. Lower-quality nursing work environment was evaluated on Hospital readmissions at 7, 30, and 90 days. Higher quality nursing work environments were associated with a greater reduction in the odds of 7-, 30-, and 90-day readmissions for older Hispanic surgical patients than non-Hispanic White patients.