Document Detail


The impact of hospital-based skilled nursing facility closures on rehospitalizations.
MedLine Citation:
PMID:  23033808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the effect of reductions in hospital-based (HB) skilled nursing facility (SNF) bed supply on the rate of rehospitalization of patients discharged to any SNF from zip codes that lost HB beds.
DATA SOURCE: We used Medicare enrollment records, Medicare hospital and SNF claims, and nursing home Minimum Dataset assessments and characteristics (OSCAR) to examine nearly 10 million Medicare fee-for-service hospital discharges to SNFs between 1999 and 2006.
STUDY DESIGN: We calculated the number of HB and freestanding (FS) SNF beds within a 22 km radius from the centroid of all zip codes in which Medicare beneficiaries reside in all years. We examined the relationship between HB and FS bed supply and the rehospitalization rates of the patients residing in corresponding zip codes in different years using zip code fixed effects and instrumental variable methods including extensive sensitivity analyses.
PRINCIPAL FINDINGS: Our estimated coefficients suggest that closure of 882 HB homes during our study period resulted in 12,000-18,000 extra rehospitalizations within 30 days of discharge. The effect was largely concentrated among the most acutely ill, high-need patients.
CONCLUSIONS: SNF patient-based prospective payment resulted in closure of higher cost HB facilities that had served most postacute patients. As other, less experienced SNFs replaced HB facilities, they were less able to manage high acuity patients without rehospitalizing them.
Authors:
Momotazur Rahman; Jacqueline S Zinn; Vincent Mor
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-04
Journal Detail:
Title:  Health services research     Volume:  48     ISSN:  1475-6773     ISO Abbreviation:  Health Serv Res     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-13     Completed Date:  2013-05-06     Revised Date:  2014-04-02    
Medline Journal Info:
Nlm Unique ID:  0053006     Medline TA:  Health Serv Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  499-518     Citation Subset:  IM    
Copyright Information:
© Health Research and Educational Trust.
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MeSH Terms
Descriptor/Qualifier:
Fee-for-Service Plans
Health Facility Closure / statistics & numerical data*
Health Services Research
Hospital Administration / statistics & numerical data*
Hospital Bed Capacity
Humans
Medicare / statistics & numerical data
Patient Readmission / statistics & numerical data*
Residence Characteristics
Skilled Nursing Facilities / organization & administration*,  statistics & numerical data*
Socioeconomic Factors
United States
Grant Support
ID/Acronym/Agency:
P01 AG027296/AG/NIA NIH HHS; P01AG027296/AG/NIA NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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