Guideline adherence scores lower in hospitals with higher percentage of births paid by Medicaid
By Lori Solomon HealthDay Reporter
THURSDAY, April 6, 2023 (HealthDay News) — Nurse staffing inconsistent with national standards is more likely to be reported in hospitals serving patients with higher rates of medical or obstetric complications, according to a study published in the May-June issue of Nursing Outlook.
Kathleen R. Simpson, Ph.D., R.N., from Mercy Hospital Saint Louis, and colleagues examined the relationship between hospital characteristics and adherence with Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) nurse staffing guidelines. The analysis included survey responses from 3,471 registered nurses and hospital characteristics from the 2018 American Hospital Association Annual Survey.
The researchers found that overall, nurses reported strong adherence to AWHONN staffing guidelines, with at least 80 percent of respondents rating their hospitals as frequently or always meeting guidelines. Lower mean guideline adherence scores were reported for hospitals with higher birth volume, a neonatal intensive care unit, teaching status, and higher percentage of births paid by Medicaid.
“Studies show that Medicaid pays hospitals less than half of what commercial insurers pay for a birth. This inequity in reimbursement creates a fiscal challenge in hospitals with a high percentage of maternity patients insured by Medicaid,” Simpson said in a statement. “Better funding for teaching and safety-net hospitals caring for high-risk maternity patients could support better nurse staffing.”
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