Number of Nurses Tied to Hospital Readmissions Outcomes: Study

Increased nurse staffing levels could be the key to helping hospitals avoid reimbursement penalties for avoidable readmissions, suggests a new study tying rehospitalizations of Medicare patients to staffing ratios. 

The research, published in the October Health Affairs journal, studied Medicare beneficiaries who had suffered heart attacks, heart failure, or pneumonia and were readmitted at more than 2,800 hospitals in conjunction with those hospitals’  nurse staffing levels.

Hospitals with higher nurse-to-patient ratios had 25% lower odds of being penalized for readmissions, researchers at the University of Pennsylvania found, compared to those with lower nurse staffing ratios.


In fiscal year 2013, hospitals were fined about $280 million in penalties for avoidable readmissions. 

For each additional nurse hour per patient day, the hospital gained a 10% lower odds of receiving penalties from the Affordable Care Act’s Hospital Readmissions Program, the researchers estimated. 

“Our findings highlight a component of the hospital care delivery system that can be targeted to limit hospitals’ exposure to readmissions penalties while improving patient outcomes,” the authors wrote. “By focusing on a system factor such as nurse staffing, administrators may be able to address multiple quality issues while reducing their likelihood of penalty for excess readmissions.”


Nurses are responsible for many activities believed to reduce preventable readmissions, such as care coordination post-discharge, overseeing in-hospital care, and planning patients’ discharge from the hospital and post-discharge medication routine. 

While it’s intuitive that adequate staffing and resources would help readmission rates decline, the researchers say hospitals should take note of their findings.

“This study strongly supports the idea that nurse staffing is one key component of healthcare delivery that hospitals can address to both improve patient outcomes and reduce the likelihood of being penalized for excessive readmissions.”

Access the full study.  

Written by Alyssa Gerace