# A Panel Study of Hospital Nursing Resources and Racial Disparities in Elder Outcomes

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2020 · $330,050

## Abstract

A Panel Study of Hospital Nursing Resources and Racial Disparities in Elder Outcomes
More than 10 years since the Institute of Medicine's landmark Unequal Treatment report, racial and ethnic
disparities in costly and often preventable poor outcomes persist for hospitalized older adults. Evidence points
to differences in the hospitals where minorities and whites receive care as a source of disparities. Our original
study findings suggest that nursing resource differences (nurse staffing, nurses' educational and skill levels,
and nurse work environments) between hospitals may be an important factor underlying racial disparities. Our
work thus far however has been restricted to cross-sectional data, preventing us from concluding whether the
relationship between nursing resources and disparities is a causal one and whether interventions to improve
nursing resources will work as intended. The study we propose in this renewal application takes the important
next step to advance policy interventions by using new and unique panel data on hospital nursing and older
adult patient outcomes in four large states to evaluate whether differences in outcomes between minority and
white patients result from differences between minority and white patients, differences in nursing resources in
the hospitals that minority and white patients receive care in, and/or differences in the care minority and white
patients receive, even when they are treated in the same hospitals with similar nursing resources. We make
efficient use of existing data from repeated cross-sections of hundreds of thousands of patients nested in a
panel of over six hundred hospitals at two points in time. This provides a unique opportunity to examine well-
known but poorly understood disparities from two distinct but complementary vantage points. First, by
examining cross-sections spanning nearly a decade, we gain a better understanding of the role of individual
and organizational factors in disparities in older adult hospital outcomes. Importantly, we will learn whether
associations between nursing and outcomes disparities in 2015 are similar to those in the same hospital
sample in 2006 and whether they differ for whites and minorities. Evidence supporting the stability of
associations over time increases our warrant for concluding that connections are causal. Our second aim is to
examine hospital-level changes in nursing resources over time, determine whether those changes differed for
hospitals predominantly serving minority patients, and determine whether changes in outcomes disparities
between minority and white patients result from changes in hospital nursing resources over time. It is important
for causation and policy implications to know whether nursing resources improved less in minority serving
hospitals. The panel data we will analyze will allow us to assess this, and to determine whether hospital
outcomes disparities have grown (or narrowed) and whether nursing resource changes are li...

## Key facts

- **NIH application ID:** 9755295
- **Project number:** 5R01AG041099-06
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Matthew D. McHugh
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $330,050
- **Award type:** 5
- **Project period:** 2011-09-15 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9755295

## Citation

> US National Institutes of Health, RePORTER application 9755295, A Panel Study of Hospital Nursing Resources and Racial Disparities in Elder Outcomes (5R01AG041099-06). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/9755295. Licensed CC0.

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