The Influence of Nurse Education Level on Hospital Readmissions—A Cost-Effectiveness Analysis

Beata Wieczorek-Wójcik, Aleksandra Gaworska-Krzemińska, Aleksander Owczarek, Michał Wójcik, Monika Orzechowska and Dorota Kilańska
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Beata Wieczorek-Wójcik: Department of Nursing and Medical Rescue, Pomeranian University in Slupsk, 76-200 Slupsk, Poland
Aleksandra Gaworska-Krzemińska: Institute of Nursing and Midwifery, Medical University of Gdansk, 80-210 Gdansk, Poland
Aleksander Owczarek: Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland
Michał Wójcik: Rehazentrum Walenstadtberg, Chnoblisbüel 1, CH-8881 Walenstadtberg, Switzerland
Monika Orzechowska: Rehazentrum Walenstadtberg, Chnoblisbüel 1, CH-8881 Walenstadtberg, Switzerland
Dorota Kilańska: Department of Coordinated Care, Medical University of Lodz, 90-419 Lodz, Poland

IJERPH, 2022, vol. 19, issue 7, 1-15

Abstract: Background: Readmissions are adverse, costly, and potentially preventable. The study aimed to evaluate the cost-effectiveness of reducing readmissions resulting from missed care, depending on the level of education of nurses, from the perspective of the service provider. Methods: We calculated missed care resulting in additional readmissions based on the longitudinal study conducted between 2012 and 2014, as well as readmissions that could have been potentially prevented by adding a 10% increase in hours of nursing care provided by BSN/MSc nurses for 2014. The cost-effectiveness analysis (CEA) was performed to calculate the cost-effectiveness of preventing one hospitalization in non-surgical and surgical wards by increasing the number of nursing hours provided by BSN/MSc nurses. Cost–benefit analysis (CBA) was performed, and the CBR (cost–benefit ratio) and BCR (benefit–cost ratio) were calculated. Results: Increasing the number of hours of nursing care (RN) by 10% decreased the chance for an unplanned readmission by 11%; (OR = 0.89; 95% CI: 0.78−1.01; p = 0.08) in non-surgical wards and 43% (OR = 0.57; 95% CI: 0.49−0.67; p < 0.001) in surgical wards. In non-surgical wards, the number of readmissions that were preventable with extra hours provided by BSN/MSc nurses was 52, and the cost-effectiveness ratio (CER) was USD 226.1. The number of preventable readmissions in surgical wards was 172, and the CER was USD 54.96. In non-surgical wards, the CBR was USD 0.07, while the BCR was USD 1.4. In surgical wards, the CBR was USD 0.02, and the BCR was USD 4.4. Conclusions: The results of these studies broaden the understanding of the relationship among nursing education, patient readmission, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification. Hence, the authors recommend it for approval by the service provider.

Keywords: cost-effectiveness analysis; education level; nurse staffing; readmissions; missed care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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