- Title Information
- Title
- The Influence of Medicaid and Medicare Policies on Hospitalizations
- Name:
Personal
- Name Part
- Unruh, Mark A
- Role
- Role Term:
Text
- creator
- Origin Information
- Copyright Date
- 2012
- Physical Description
- Extent
- x, 64 p.
- digitalOrigin
- born digital
- Note
- Thesis (Ph.D. -- Brown University (2012)
- Name:
Personal
- Name Part
- Mor, Vincent
- Role
- Role Term:
Text
- Director
- Name:
Personal
- Name Part
- Trivedi, Amal
- Role
- Role Term:
Text
- Reader
- Name:
Personal
- Name Part
- Chay, Kenneth
- Role
- Role Term:
Text
- Reader
- Name:
Personal
- Name Part
- Grabowski, David
- Role
- Role Term:
Text
- Reader
- Name:
Corporate
- Name Part
- Brown University. Health Services Research
- Role
- Role Term:
Text
- sponsor
- Genre (aat)
- theses
- Subject
- Topic
- hospitalization
- Subject
- Topic
- rehospitalization
- Subject (FAST)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/1014815")
- Topic
- Medicare
- Subject (FAST)
(authorityURI="http://id.worldcat.org/fast", valueURI="http://id.worldcat.org/fast/1013657")
- Topic
- Medicaid
- Record Information
- Record Content Source (marcorg)
- RPB
- Record Creation Date
(encoding="iso8601")
- 20121023
- Language
- Language Term:
Code (ISO639-2B)
- eng
- Language Term:
Text
- English
- Abstract
- Preventable hospitalizations have garnered a significant amount of attention among researchers and policymakers. Although most hospitalizations are medically necessary, the large amount of geographic variation seen in the United States indicates that some are discretionary. As such, reducing rates of hospitalization represents a means to improve the quality of care and reduce costs. This study evaluated the impact of Medicare’s post-acute care (PAC) transfer policy on 30-day readmissions of hospital discharges to skilled nursing facilities (SNFs) and the influence of states’ Medicaid bed-hold policies on hospitalization of long-stay nursing home (NH) residents. <br/>
<br/>
Medicare’s PAC transfer policy reduces payments to hospitals for patients discharged to Medicare-paid PAC prior to meeting pre-determined thresholds for length of stay (LOS). Using a national sample of hospital discharges to SNFs from 1999 through 2005, this study found that implementation of the policy led to decreases in hospital LOS for case diagnosis related groups consisting of individuals with acute myocardial infarction with and without major complications, heart failure, and kidney or urinary tract infections with and without major complications. LOS for a control group of patients with septicemia was not affected. Declines in LOS were associated with an increased likelihood of 30-day rehospitalization for acute myocardial infarction with major complications and kidney or urinary tract infections without major complications, but not other case diagnosis related groups. <br/>
<br/>
States’ Medicaid bed-hold policies reimburse NHs to hold beds so that hospitalized residents covered by Medicaid may return to their facility of occupancy following hospital discharge. These payments may create a financial incentive to hospitalize residents. Additionally, the effect of these policies on racial disparities in hospitalizations occurring within NHs is unknown. Using a nationwide sample of long-stay residents from 2000 through 2005, this study found a significant relationship between presence of an active bed-hold policy and increased likelihood of hospitalization. However, the policies were not associated with racial disparities in hospitalizations arising within NHs. <br/>
<br/>
As significant changes are made to public health care programs in the upcoming years, payment reform policies may have important negative unintended consequences. <br/>
- Identifier:
DOI
- 10.7301/Z0K072KF
- Access Condition:
rights statement
(href="http://rightsstatements.org/vocab/InC/1.0/")
- In Copyright
- Access Condition:
restriction on access
- Collection is open for research.
- Type of Resource (primo)
- dissertations