Table 3.

Effects of Percentage of Black Patients in Hospitals, Nurse Staffing and Nurse Work Environment on HCAHPS Outcomes (n = 429)

HCAHPS outcom (% of patients that agree with statement)	Unadjusted parameter estimate	P	Partially adjusted for nursing characteristics	P	Partially adjusted for hospital characteristics	P	Fully Adjusted with state dummies/ response rate	P
Patients who would definitely recommend the hospital
Concentration of Blacks (<11%; reference)
11%–23%	−2.74	<.05	−2.91	<.01	−3.90	.001	−2.60	.02
> 23%	−3.46	<.05	−2.52	.09	−4.27	<.01	−1.39	.35
Nurse staffing			−0.93	<.05			−1.47	<.01
Nurse work environment			5.26	<.001			4.54	<.001
Nurses always communicated well
Concentration of Blacks (<11%; reference)
11%–23%	−2.75	<.01	−2.36	<.01	−2.37	<.01	−0.91	.22
> 23%	−1.43	.21	−1.08	.32	−.47	.68	0.67	.51
Nurse staffing			1.18	<.001			−.56	.11
Nurse work environment			2.62	<.001			2.16	<.001
Patients always received help as soon as they wanted
Concentration of Blacks (<11%; reference)
11%–23%	−3.24	<.001	−2.84	<.01	−2.27	.01	−0.81	.34
> 23%	−2.95	<.05	−2.71	<.05	−1.22	.32	−0.18	.88
Nurse staffing			1.28	<.001			−.68	.08
Nurse work environment			2.02	<.001			1.72	<.001
Staff gave patients discharge information
Concentration of Blacks (<11%; reference)
11%–23%	−1.72	<.01	−1.66	<.01	−1.05	.06	−0.27	.61
> 23%	−1.21	.12	−0.96	.20	0.25	.74	0.96	.17
Nurse staffing			0.09	.68			−.77	.001
Nurse work environment			1.54	<.001			1.58	<.001

Note. Partially adjusted models included controls for nursing (nurse staffing and nurse work environment) or hospital characteristics (core based statistical area (division, metro, micro, rural), bedsize, ownership and teaching status). Parameter estimates for concentration of Blacks represent the change in the percentage of patients reporting the outcome associated with being in hospitals where 11–23% as opposed to less than 11% of the patients are Black, and in hospitals where >23% as opposed to less than 11% of the patients are Black. Parameter estimates for nurse staffing represent the change in the percentage of patients reporting the outcome associated with an increase of one patient per nurse. Parameter estimates for nurse work environment represent the change in the percentage of patients reporting the outcome associated with working in hospitals with better vs. mixed (or with mixed vs. poor) environments The fully adjusted model includes dummy variables for state (California, Florida, New Jersey, and Pennsylvania) and HCAHPS response rate.