Department of Nursing and Medical Rescue, Pomeranian University in Slupsk, 76-200 Slupsk, Poland.
Institute of Nursing and Midwifery, Medical University of Gdansk, 80-210 Gdansk, Poland.
Int J Environ Res Public Health. 2022 Mar 31;19(7):4177. doi: 10.3390/ijerph19074177.
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.
再入院是不利的、昂贵的，且可能是可以预防的。本研究旨在从服务提供者的角度评估减少因护理缺失而导致的再入院的成本效益，具体取决于护士的教育水平。
我们根据 2012 年至 2014 年进行的纵向研究，计算了因护理缺失而导致的额外再入院的次数，以及通过增加学士学位/硕士学位护士的护理时间（2014 年增加 10%）本可以预防的再入院次数。我们进行了成本效益分析（CEA），以计算通过增加学士学位/硕士学位护士提供的护理时间来预防非外科和外科病房中一次住院的成本效益。我们进行了成本效益分析（CBA），并计算了成本效益比（CBR）和效益成本比（BCR）。
增加 10%的护理时间使非外科病房中计划外再入院的机会降低了 11%（OR = 0.89；95%CI：0.78−1.01；p = 0.08），外科病房中降低了 43%（OR = 0.57；95%CI：0.49−0.67；p < 0.001）。在非外科病房中，由 BSN/MSc 护士提供额外护理时间可以预防的再入院次数为 52 次，成本效益比（CER）为 226.1 美元。在外科病房中，可预防的再入院次数为 172 次，成本效益比（CER）为 54.96 美元。在非外科病房中，成本效益比（CBR）为 0.07 美元，效益成本比（BCR）为 1.4 美元。在外科病房中，成本效益比（CBR）为 0.02 美元，效益成本比（BCR）为 4.4 美元。
这些研究结果拓宽了对护理教育、患者再入院和医院护理经济结果之间关系的理解。作者认为，拟议的干预措施具有经济合理性。因此，作者建议服务提供者批准该干预措施。
