{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T02:25:27Z","timestamp":1785378327105,"version":"3.55.0"},"reference-count":55,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Research in Nursing &amp; Health"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The purpose of this study was to examine the association between hospital nurse staffing levels and 30\u2010 and 60\u2010day readmissions among patients with intellectual and\/or developmental disabilities (IDD). This cross\u2010sectional correlational study utilized secondary data from 595 acute care, nonfederal hospitals in California, Florida, New Jersey, and Pennsylvania in 2016. Data were obtained from three sources: the American Hospital Association Annual Survey, the RN4CAST\u2010US nurse survey, and state patient hospital discharge summaries. The analytic sample included 39,558 hospital stays for 28,446 adults with IDD aged 18 and older who were discharged alive. In adjusted models, every additional patient added to a nurse's workload was associated with 7% higher odds of 30\u2010day readmission OR\u2009=\u20091.07 (95% CI [1.03, 1.12],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001) and 9% higher odds of 60\u2010day readmission OR\u2009=\u20091.09 (95% CI [1.04, 1.13],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) among patients with IDD. The average nurse staffing level across hospitals was 4.7 patients per nurse (SD\u2009=\u20090.99). Staffing levels varied by hospital characteristics, with large hospitals, major teaching hospitals, and hospitals in California having better staffing ratios. The study population had a 30\u2010day readmission rate of 17.1%, which is 27% higher than the average adult hospital 30\u2010day readmission rate in the US in 2018. This study demonstrates the association of nurse staffing levels with readmission odds for patients with IDD. Improving nurse staffing levels is a system\u2010based solution that can potentially improve outcomes for patients with IDD, who often require intensive nursing care.\n                  <\/jats:p>","DOI":"10.1002\/nur.70013","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T14:14:52Z","timestamp":1754921692000},"page":"675-684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Associations Between Nurse Staffing Levels and 30\u2010 and 60\u2010Day Readmissions for Acute Care Patients With Intellectual and Developmental Disability"],"prefix":"10.1002","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5875-4203","authenticated-orcid":false,"given":"Lynne S.","family":"Moronski","sequence":"first","affiliation":[{"name":"Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing Philadelphia PA USA"},{"name":"Leonard Davis Institute for Health Economics University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen T.","family":"Lake","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing Philadelphia PA USA"},{"name":"Leonard Davis Institute for Health Economics University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"McHugh","sequence":"additional","affiliation":[{"name":"Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing Philadelphia PA USA"},{"name":"Leonard Davis Institute for Health Economics University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.16.1987"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-6773.2010.01114.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1352\/1934-9556-52.3.187"},{"key":"e_1_2_10_5_1","unstructured":"American Association on Intellectual and Developmental Disabilities.2025.Defining Criteria for Intellectual Disability.https:\/\/www.aaidd.org\/intellectual-disability\/definition."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-018-0316-9"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jir.12601"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2333392821993704"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.201600534"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.4037\/aacnacc2022746"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCQ.0000000000000475"},{"key":"e_1_2_10_12_1","unstructured":"California Legislative Information.1999.Assembly Bill 394 Analytics.http:\/\/www.leginfo.ca.gov\/pub\/99-00\/bill\/asm\/ab_0351-0400\/ab_394_cfa_19990708_164003_sen_comm.html."},{"key":"e_1_2_10_13_1","unstructured":"Centers for Disease Control and Prevention.2024. 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