Agency for Healthcare Research and Quality,Grant # R01 HS13094 Hospital Payment, Nurse Staffing, and the Outcomes of Patient Care Mei Zhao, Ph.D. University.

Slides:

Advertisements

Similar presentations

Sustaining Safety Net Hospitals Supporting Access, Quality & Efficiency Alliance for Health Reform Washington, DC June 4, 2012.

Advertisements

Adverse Patient Safety Events: Costs of Readmissions and Patient Outcomes Following Discharge Didem M. Bernard, Ph.D. William E. Encinosa, Ph.D.

Variations in Quality Outcomes Among Hospitals in Different Types of Health Systems, Askar Chukmaitov, M.D., M.P.A. Askar Chukmaitov, M.D.,

Is JCAHO Accreditation Associated with Better Patient Outcomes in Rural Hospitals? Laura Morlock, PhD Bloomberg School of Public Health Johns Hopkins University.

Is There a Relationship Between Hospital Safety Culture and Safety Outcomes in VA Hospitals? Amy K. Rosen, Ph.D. 1,2, Sara Singer, Ph.D. 3,Christine Hartmann,

Providing Insights that Contribute to Better Health Policy Health Plans’ Use of Quality Incentives and Information: Findings from the Community.

Being The Change: Safer Nurse to Patient Ratio’s Gina L. Gilmore, RNGina L. Gilmore, RN James Madison UniversityJames Madison University.

Gentiva Health Services, Inc.. Forward-Looking Statements This presentation should be considered forward-looking and is subject to various risk factors.

Present on Admission. Requirements of Deficit Reduction Act 2005 CMS and CDC choose conditions that are: High Cost, High Volume, or both. Assigned to.

It’s A Success! Achieving Cost-Effective Disease Management in CHF Sherry Shults, RN BSN CIO South Carolina Heart Center.

Measuring Disparities in Patient Safety Ernest Moy

Quality Indicators & Safety Initiative: Group 4, Part 3 Kristin DeJonge Ferris Stat University MSN Program.

Jessica Riley Ferris State University  Determine risks of patient outcomes related to lack of adequate staffing.  Understand causative factors to risks.

1 The Effects of Information Technology on Nurses and Patients in the VHA Joanne Spetz, Ph.D. University of California, San Francisco Ciaran Phibbs, Ph.D.

Agency For Healthcare Quality and Research Quality Indicators NH Health Care QA Commission AHRQ Subcommittee Report July 31, 2009.

Combining the AHRQ Indicator Sets to Assess the Health of Communities: Powerful information for planning purposes Susan McBride, PhD, RN Dallas-Fort Worth.

The Status of Patient Safety Donald M. Berwick, MD, President and CEO Institute for Healthcare Improvement 10 th Anniversary of To Err is Human The Commonwealth.

1 An Evaluation of Hospital Capital Investment after Balanced Budget Act Tae-Hyun “Tanny” Kim, MPH Michael J. McCue, DBA Virginia Commonwealth University.

The Big Picture: A Look at Hospitals in a Volatile Healthcare Environment Gloria J. Bazzoli, Ph.D. Professor of Health Administration Virginia Commonwealth.

Patient- and Family-Centered Care — What is it? Patient- and family- centered care is working with, rather than doing to or for.

INFLUENCE OF MEANINGFUL USE AMONG HEALTHCARE PROVIDERS Neely Duffey, Olivia Mire, Mallory Murphy, and Dana Sizemore.

Panel on Measuring Quality and Value Carolyn M. Clancy, MD Director Agency for Healthcare Research and Quality IOM Committee Meeting on Geographic Variation.

How Much Does Medicare Pay Hospitals for Adverse Events? Building the Business Case for Investing in Patient Safety Improvement Chunliu Zhan, MD, PhD,

Hospital Ownership Form and Quality Changes: Changes in Nurse Staffing and Failure-to-Rescue following the BBA of 1997 David K. Song, M.D., Ph.D. Kevin.

Comparative Rankings of Hospital Quality – Does the Data Source Matter? Anne Elixhauser, Ph.D. Bernard Friedman, Ph.D. June 26, 2005 AcademyHealth Research.

Jesse M. Pines, MD, MBA, MSCE Associate Professor of Emergency Medicine and Health Policy George Washington University September 27, 2010.

Exploratory Analysis of Observation Stay Pamela Owens, Ph.D. Ryan Mutter, Ph.D. September, 2009 AHRQ Annual Meeting.

What do we know about overall trends in patient safety in the USA? Patrick S. Romano, MD MPH Professor of Medicine and Pediatrics University of California,

Ending Health Disparities: Health, Environmental, and Social Justice in the Caribbean and Beyond Panel discussion on Health and Social Justice from the.

1 1 Survey of Patient Safety Culture in U.S. Hospitals: External Validity Analyses Russ Mardon, Ph.D. Westat 2008 AHRQ Annual Conference Westat 1650 Research.

Impact of Restrictive State Policies on Utilization and Expenditures in the Medicaid Program Roberto Vargas, MD, MPH 1,2 Carole Gresenz, PhD 2 Jessie Riposo,

Private Hospitals and the Treatment of Severe Mental Illness: The Role of the Emergency Department Presented by: Richard C. Lindrooth, Ph.D. Medical University.

Quality of Care in Physician Groups Do Larger Integrated Systems Deliver Higher Quality Care? Ateev Mehrotra MD MPH RAND Pittsburgh & University of Pittsburgh.

Does Hospital Price Competition Influence Nurse Staffing and Quality of Care? Julie Sochalski, PhD 1 R. Tamara Konetzka, PhD 2 Jingsan Zhu, MBA 1 Joanne.

What Do Workforce Issues Have To Do With Patient Safety? Jack Needleman, Ph.D. Assistant Professor of Economics and Health Policy Department of Health.

The Effects of Financial Pressures on the Hospital Safety Net Gloria J. Bazzoli, Ph.D. (VCU) Richard C. Lindrooth, Ph.D. (MUSC) Romana Hasnain-Wynia, Ph.D.

Volume-Outcome Relationship: An Econometric Approach to CABG Surgery Hsueh-Fen Chen (VCU) Gloria J. Bazzoli (VCU) Askar Chukmaitov (FSU) Funded by the.

AHRQ PSIs and IQIs in National Pay for Reporting September 14, 2009 AHRQ QI Conference Shaheen Halim, Ph.D. Centers for Medicare & Medicaid Services.

Hospital Safety: Do race and ethnicity matter? Ernest Moy, MD, MPH Elizabeth Dayton, MA Roxanne Andrews, PhD The Agency for Healthcare Research and Quality.

Rural Hospital Collaborative for Excellence Using IT AHRQ UC1 HS15431 Kathy Mechler, MS, RN, CPHQ Texas A&M University Health Science Center Rural and.

Using AHRQ Quality Indicators Denise Remus PhD, RN Senior Research Scientist Agency for Healthcare Research and Quality (AHRQ)

The State Innovation Model National Efforts to Transform Health Care in Iowa 100 E. Grand Ave., Ste. 360 Des Moines, IA Office:

Nursing Home Costs and Quality: Is There a Tradeoff? Robert Weech-Maldonado, Ph.D. Department Health Services Research, Management and Policy University.

The Nurse Staffing and Human Capital on Patient Outcomes for VA Inpatient Care The Impact of Nurse Staffing and Human Capital on Patient Outcomes for VA.

A Profile of Patient Care and Safety in Hospitals with Differing Case-Mix and Financial Condition Sema K. Aydede, PhD Institute for Child Health Policy,

Informing Medicare Policy on Post- acute Care: The “Missing Million” AcademyHealth 2004 Annual Research Meeting Sharon Bee Cheng, MS Christopher Hogan,

Varied Regional Responses to Medicare Post-Acute Care (PAC) Prospective Payment Systems 1. Department of Family and Community Medicine, University of Missouri-Columbia.

How much of the variation in hospital financial performance is explained by service mix? Presented by: Richard Lindrooth Medical University of South Carolina.

Vantage Care Positioning System®: Make Your Case with Medicare Spending Data November 2014 avalere.com.

The Effect of Hospitals’ Post-Acute Care Ownership on Medicare Post-Acute Care Use 1. Department of Family and Community Medicine, University of Missouri-Columbia.

Agency for Healthcare Research and Quality,Grant # R01 HS13094 Hospital Financial Distress and Patient Outcome: A Panel Study Mei Zhao, MHA Virginia Commonwealth.

1 The Impact of Volume of Outpatient Surgical Procedures on Quality Outcomes: AcademyHealth: June 4, 2007.

Value of Pharmacy Services January 31 st (A), 2011 J. Hirsch, Ph.D. SSPPS – 207 Introduction to Health Care Systems and Policy.

Nurse Staffing and Quality of Care for Hospitalized Children Barbara A. Mark Ph.D., R.N. FAAN University of North Carolina at Chapel Hill David W. Harless.

And Patient Outcomes Do Magnet organizations provide a safer work environment with better patient outcomes? By Sandra Gilman, Stephanie Gulledge, Kim.

MQMS: Patient Safety Among Medicare Beneficiaries Arnold Chen, M.D., M.Sc. (MPR) David Hunt, M.D. (CMS) Sheila Roman, M.D., M.P.H. (CMS) Lein Han, Ph.D.

Hospital Use of Supplemental Nurses and Patient Mortality and Failure to Rescue Jingjing Shang, PhD, RN Columbia University School of Nursing Ying Xue,

How To Improve Performance on the AHRQ Inpatient Quality and Patient Safety Indicators: Introducing a Toolkit for Hospitals Webinar February 15, :30-4:00.

Trends in Financial and Operating Performance of Rehabilitation Hospitals Under the Rehabilitation Prospective Payment System Jon M. Thompson, Ph.D. Professor.

Brian C. Martin, Ph.D., MBA East Tennessee State University

Disparities in Chronic Disease Management and Prevention: Findings from the 2006 National Healthcare Quality Report Authors: Anika Hines, MPH; Karen Ho,

Copyright © 2014 American Medical Association. All rights reserved.

Volume 11, Issue 4, Pages (July 2011)

The Influence of Professional and Physical Isolation on Enabling Evidence-based Nursing Practice in Rural Hospitals Robin P. Newhouse, PhD, RN, CNA, CNOR.

Present By:- Company Name: Global Market Forecastes Tel: / Web:

Evidence Based Practice: Do Nursing Shortages Affect Patient Outcomes?

Volume 11, Issue 4, Pages (July 2011)

Entrepreneurship, Strategy and Information Systems

Volume 11, Issue 4, Pages (July 2011)

Evidence Based Practice

Presentation transcript:

Agency for Healthcare Research and Quality,Grant # R01 HS13094 Hospital Payment, Nurse Staffing, and the Outcomes of Patient Care Mei Zhao, Ph.D. University of North Florida Gloria J. Bazzoli, Ph.D. Virginia Commonwealth University

Rationale for the Study US hospital payment has been declining during the last several years Hospitals have been cutting staffing due to financial pressures Studies found that higher nurse staffing ratio is related to better patient outcomes, but most of these studies are cross-sectional Few studies ever examined the relationship among hospital payment, staffing decisions, and patient outcomes

Research Questions What is the effect of hospital payment on the quality of care and patient safety? What is the effect of hospital nurse staffing on the quality of care and patient safety?

Method Design A panel study design is applied to data from Sampling Nonfederal short term general hosps from 11 states (AZ, CA, CO, FL, IA, MD, MA, NJ, NY,WA, and WI), about 1,100 per year Data Sources AHA, MCR, ARF, HCUP (SID)

Key Variables Payment Net patient revenue per adjusted patient day Staffing Indicators RNs per adjusted patient day LPNs per adjusted patient day Patient Outcomes IQIs (4): AMI, CHF, Stroke, and Pneumonia PSIs (4): Decubitus ulcer, infections due to medical care, post-op pulmonary embolism, and sepsis

Analytic Strategies Panel Analysis Fixed-effects Models

Conclusions Hospitals experiencing a decline in payment may compromise the care they provide to patients, but the impact is limited Hospital quality of patient care is only weakly related to changes in hospital nurse staffing Patient outcomes are influenced by the volume of care a hospital provides and its experience in treating severely ill patients

Significance to Policy and Future Research Health policy efforts focused on improving hospital quality should consider regionalization of certain types of care more so than implementing minimum staffing levels or enhancing hospital reimbursement Even if the relationship between patient outcomes and changes in staffing levels is minimal, it is important to investigate how staffing reductions may affect employee morale and productivity Many other patient outcome measures were not included