期刊
NURSING OUTLOOK
卷 65, 期 6, 页码 689-696出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.outlook.2017.08.011
关键词
Missouri Quality Initiative; Medicare; Nurse practitioners; Long-term care facilities
类别
资金
- Centers for Medicare and Medicaid Innovations Center [1E1CMS331080]
- Medicare Medicaid Coordination Office [1E1CMS331080]
Background: Centers for Medicare and Medicaid Innovation Center sponsored the initiative to reduce avoidable hospitalizations among nursing facility residents. Purpose: Missouri Quality Initiative (MOQI) designed inter-professional model in nursing homes with advanced practice registered nurses (APRNs). Method: MOQI APRN model was implemented for 4 years in 16 nursing homes in a metro area of the Midwest. Hospitalizations were reduced (40% all-cause, 58% potentially avoidable), emergency room visits (54% all-cause, 65% potentially avoidable), Medicare expenditures for hospitalizations (34% all-cause, 45% potentially avoidable), and Medicare expenditures for emergency room visits (50% all-cause, 60% potentially avoidable) for long-stay nursing home residents. Discussion: Success of the MOQI model reinforces decades of research demonstrating that care provided by APRNs is cost-effective, safe, and associated with positive health outcomes and patient satisfaction. Conclusion: Nursing homes can implement and benefit by hiring APRNs. However, changes in the Code of Federal Regulation (CFR 483.40) are necessary to improve patient access to care and encourage hiring APRNs in US nursing homes.
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