The Moderating Role of Hospital Staffing Levels on the Effectiveness of Clinical Decision Support Systems in Mitigating Patient Readmission Rates: An Empirical Analysis

Healthcare staffing shortages and high 30-day readmission rates are pressing challenges in today's healthcare systems. While extensive studies have explored the positive impact of Health Information Technology (HIT) on health outcomes, the effect of hospital staffing on HIT effectiveness, particularly Clinical Decision Support Systems (CDSS), is underexplored. Therefore, we examine whether physician and resident staffing levels moderate the impact of CDSS on 30-day readmission rates. After analyzing data from 1,605 hospitals in the United States from 2017 and 2018, we found that the effect of CDSS implementation in reducing 30-day readmission rates is more pronounced in hospitals with lower bed-to-physician and bed-to-resident ratios, suggesting a higher number of physicians and residents per bed enhances the effectiveness of CDSS. The study also highlights different effects based on hospital size and complexity levels and emphasizes the importance of considering staffing levels when implementing CDSS and other HIT to maximize their benefits.