Estimating the effect of New Jersey's 2005 administrative nurse mandate on mortality and hospitalizations for medicare hemodialysis patients.

ABSTRACT

BACKGROUND AND OBJECTIVES: In 2005, the New Jersey Department of Health enacted a rule requiring that an administrator or designate always be present in a hemodialysis clinic and that the individual may not be involved in patient care activities at any time. Our investigation examines the effect of this unique rule on patient mortality and hospitalizations and is meant to inform the public policy discussion. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS We utilized a synthetic control estimation to analyze the effect of this rule on patient mortality in New Jersey. We also compared trends for hospitalizations in New Jersey to other similar states. RESULTS: We find no evidence that the law affected patient mortality or the number of hospitalizations for Medicare patients in New Jersey. CONCLUSIONS: The New Jersey law poses substantial costs to hemodialysis clinics and we find little evidence of any measurable benefit to patients.