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Addressing Systemic Inequities Linked to Readmission Disparities for Minority Stroke Patients

Racial minorities are disproportionately affected by stroke, with Black patients experiencing worse post-stroke outcomes than White patients. Racial disparities in stroke outcomes have been linked to suboptimal control of risk factors such as hypertension, lack of access to health care, and decreased utilization of neurologic services. However, it was previously unknown if outcomes for Black ischemic stroke patients were affected by care settings with insufficient nursing resources.

New research from the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research (CHOPR) indicates disparities in readmissions between Black and White stroke patients may be linked to the level of nurse staffing in the hospitals where they receive care. It is the first study of its kind that demonstrates an association between nurse staffing and 7- and 30-day readmission disparities for Black ischemic stroke patients. A paper detailing the research, “Racial Disparities in Stroke Readmissions Reduced in Hospitals with Better Nurse Staffing,” has recently been published in the journal Nursing Research.

“Tailoring nurse staffing levels to meet the needs of Black ischemic stroke patients represents a promising intervention to address systemic inequities linked to readmission disparities among minority stroke patients, says J. Margo Brooks Carthon, PhD, RN, FAAN, Tyson Family Endowed Term Chair for Gerontological Research and Associate Professor of Nursing. Brooks Carthon is the lead author of the paper. “Addressing long-standing systemic inequities will require systemwide investments to raise staffing levels that allow nurses to sufficiently address the clinical and social needs of Black ischemic stroke patients.”

Co-authors of the article include Matthew McHugh, PhD, CHOPR Director; Marguerite Daus, BSN, RN; Rachel French, BSN, RN; Douglas M. Sloane, PhD, Adjunct Professor of Nursing; and Linda H. Aiken, PhD, CHOPR Founding Director, Heather Brom of the University of Villanova College of Nursing; Robert Berg of Children’s Hospital of Philadelphia; and Raina Merchant of the Hospital of the University of Pennsylvania.

This research was supported by the National Institute of Minority Health & Health Disparities (Grant No. MD011518, J. Margo Brooks Carthon, principal investigator [PI]) and the National Institutes of Nursing Research (Grant No. R01NR016002, Matthew McHugh, PI; Grant No. R01NR014855, Linda Aiken, PI; and Grant No. T32NR007104, Linda Aiken, PI).