An Evaluation of the Impact of the Prospective Payment System on Antidepressant Use in Nursing Home Residents

Bibliographic Data

ID9102671
AuthorsKate L Lapane (0000-0001-9957-7747, Rhode Island Department of Health, corresponding author), Carmel Hughes (0000-0002-4656-6021), Carmel M Hughes
Year2004
Volume42
Issue1
Pages48-58
Publication date2004-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/01.mlr.0000102294.95860.64
PMID14713739
OpenAlexW2067248722
LanguageEN
Citations received1
References cited29

OBJECTIVES: To determine the impact of the prospective payment system (PPS) for skilled nursing facilities on the pharmacologic treatment of depression. METHODS: We used a quasi-experimental study comparing the pharmacological treatment rates for depression in the pre-PPS period (1997) to the post-PPS period (2000) in 8149 residents with documented depression living in over 500 nursing facilities in Ohio. Logistic regression models adjusting for clustering effects of residents residing in homes using generalized estimating equations provided estimates of the PPS effect on use of any antidepressant and the use of selective serotonin reuptake inhibitors (SSRIs). We evaluated the extent to which the PPS effect was modified by organizational characteristics, including structural characteristics, resource characteristics, and staff resources available in the homes. RESULTS: Overall, there was no difference in the likelihood of any antidepressant [odds ratio (OR), 1.05; 95% confidence interval (CI), 0.93 to 1.18, resident-adjusted model] or an SSRI being used (OR, 0.98; 95% CI, 0.86 to 1.12, resident-adjusted model) after the introduction of PPS compared with 1997 when this reimbursement system was not in place (referent group). These trends did not appear to be modified substantially by organizational characteristics. CONCLUSION: Although PPS did not appear to have influenced the treatment of depression in nursing homes, systems that provide checks and balances in relation to PPS are warranted

Antidepressant · Business · Confidence interval · Depression (economics) · Generalized estimating equation · Health care · Logistic regression · Odds · Odds ratio · Payment · Prospective cohort study · Prospective payment system · Psychiatry · Reimbursement · Statistics · Emergency Medicine · Family Caregiving in Mental Illness · Geriatric Care and Nursing Homes · Internal Medicine · Medicine · Mental Health Treatment and Access · Nursing

Tools

Open DOISci-Hub