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Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures.
Policy Polit Nurs Pract. 2016 Nov; 17(4):177-186.PP

Abstract

It is well-established that hospitals recognized for good nursing care - Magnet hospitals - are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures. A cross-sectional analysis of three linked data sources was performed. The sample included 3,021 non-federal acute care hospitals participating in the VBP program (323 Magnets; 2,698 non-Magnets). Propensity score matching was used to match Magnet and non-Magnet hospitals with similar hospital characteristics. After matching, linear and logistic regression models were used to examine the relationship between Magnet status and VBP performance. After matching and adjusting for hospital characteristics, Magnet recognition predicted higher scores on Total Performance (Regression Coefficient [RC] = 1.66, p < 0.05), Clinical Processes (RC = 3.85; p < 0.01), and Patient Experience (RC = 6.33; p < 0.001). The relationships between Magnet recognition and the Outcome and Efficiency domains were not statistically significant. Magnet hospitals known for nursing excellence perform better on Hospital VBP measures. As healthcare systems adapt to evolving incentives that reward value, attention to nurses at the front lines may be central to ensuring high-value care for patients.

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Authors+Show Affiliations

Lasater KB
1 Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, PA, USA. 2 Leonard Davis Institute of Health Economics, University of Pennsylvania, PA, USA.
Germack HD
1 Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, PA, USA. 2 Leonard Davis Institute of Health Economics, University of Pennsylvania, PA, USA. 3 National Clinical Scholars Program, Yale University, New Haven, CT, USA.
Small DS
2 Leonard Davis Institute of Health Economics, University of Pennsylvania, PA, USA. 4 Department of Statistics, The Wharton School of the University of Pennsylvania; Philadelphia, PA, USA.
McHugh MD
1 Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, PA, USA. 2 Leonard Davis Institute of Health Economics, University of Pennsylvania, PA, USA.

MeSH

HospitalsHospitals, PrivateHospitals, PublicHumansNursing Staff, HospitalQuality Assurance, Health CareQuality Indicators, Health CareUnited StatesValue-Based Purchasing

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28558604

Citation

Lasater, Karen B., et al. "Hospitals Known for Nursing Excellence Perform Better On Value Based Purchasing Measures." Policy, Politics & Nursing Practice, vol. 17, no. 4, 2016, pp. 177-186.
Lasater KB, Germack HD, Small DS, et al. Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures. Policy Polit Nurs Pract. 2016;17(4):177-186.
Lasater, K. B., Germack, H. D., Small, D. S., & McHugh, M. D. (2016). Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures. Policy, Politics & Nursing Practice, 17(4), 177-186. https://doi.org/10.1177/1527154417698144
Lasater KB, et al. Hospitals Known for Nursing Excellence Perform Better On Value Based Purchasing Measures. Policy Polit Nurs Pract. 2016;17(4):177-186. PubMed PMID: 28558604.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hospitals Known for Nursing Excellence Perform Better on Value Based Purchasing Measures. AU - Lasater,Karen B, AU - Germack,Hayley D, AU - Small,Dylan S, AU - McHugh,Matthew D, Y1 - 2017/03/17/ PY - 2017/6/1/entrez PY - 2017/6/1/pubmed PY - 2017/10/5/medline KW - magnet hospitals KW - medicare KW - value-based care SP - 177 EP - 186 JF - Policy, politics & nursing practice JO - Policy Polit Nurs Pract VL - 17 IS - 4 N2 - It is well-established that hospitals recognized for good nursing care - Magnet hospitals - are associated with better patient outcomes. Less is known about how Magnet hospitals compare to non-Magnets on quality measures linked to Medicare reimbursement. The purpose of this study was to determine how Magnet hospitals perform compared to matched non-Magnet hospitals on Hospital Value Based Purchasing (VBP) measures. A cross-sectional analysis of three linked data sources was performed. The sample included 3,021 non-federal acute care hospitals participating in the VBP program (323 Magnets; 2,698 non-Magnets). Propensity score matching was used to match Magnet and non-Magnet hospitals with similar hospital characteristics. After matching, linear and logistic regression models were used to examine the relationship between Magnet status and VBP performance. After matching and adjusting for hospital characteristics, Magnet recognition predicted higher scores on Total Performance (Regression Coefficient [RC] = 1.66, p < 0.05), Clinical Processes (RC = 3.85; p < 0.01), and Patient Experience (RC = 6.33; p < 0.001). The relationships between Magnet recognition and the Outcome and Efficiency domains were not statistically significant. Magnet hospitals known for nursing excellence perform better on Hospital VBP measures. As healthcare systems adapt to evolving incentives that reward value, attention to nurses at the front lines may be central to ensuring high-value care for patients. SN - 1552-7468 UR - https://www.unboundmedicine.com/medline/citation/28558604/Hospitals_Known_for_Nursing_Excellence_Perform_Better_on_Value_Based_Purchasing_Measures_ DB - PRIME DP - Unbound Medicine ER -