Worse Nursing-Sensitive Indicators in Black-Serving Hospitals

Area of Science:

• Healthcare disparities
• Nursing-sensitive indicators
• Hospital quality metrics

Background:

• Hospitals serving predominantly Black patients (Black-serving hospitals) may have worse nurse staffing and higher mortality rates.
• Evidence on nursing-sensitive indicators in Black-serving hospitals is not comprehensively compiled.

Purpose of the Study:

• To investigate differences in nursing-sensitive indicators between Black-serving hospitals and other hospitals.
• To assess patient health status changes directly impacted by nursing care in diverse hospital settings.

Main Methods:

• Cross-sectional study using 2019-2022 Hospital Compare and MEDPAR data.
• Evaluated four nursing-sensitive indicators: pressure ulcer, postoperative sepsis, perioperative pulmonary embolus/deep vein thrombosis, and 'failure to rescue'.
• Hospitals categorized into high, medium, and low Black-serving based on Black patient percentage; analyses controlled for Case Mix Index (CMI).

Main Results:

• Higher rates of pressure ulcers, perioperative pulmonary emboli/deep vein thrombosis, and sepsis were observed in high Black-serving hospitals.
• No significant differences in 'failure to rescue' rates were found across hospital categories.
• Results remained consistent after adjusting for CMI.

Conclusions:

• Several nursing-sensitive indicators are demonstrably worse in high Black-serving hospitals.
• Further research is required to link nursing-sensitive indicators to nursing resources like staffing to understand underlying mechanisms.
• Poorer nursing-sensitive indicators and nurse staffing in Black-serving hospitals highlight a priority for policy and management interventions.