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Nursing Home Transfers and Mean Length of Stay in the Prospective Payment Era

Bibliographic Data

ID9103801
AuthorsGenevieve Kenney (Urban Institute), John Holahan (Urban Institute)
Year1991
Volume29
Issue7
Pages589-609
Publication date1991-07-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199107000-00001
PMID1906564
OpenAlexW2072728733
LanguageEN
Citations received2
References cited4

Under Medicare's Prospective Payment System (PPS), hospitals have incentives to discharge Medicare patients as quickly as medically feasible, but because of shortages of nursing home beds and differential long-term care arrangements, some hospitals may encounter difficulty placing patients in nursing homes, leading to hospital backup days. This study relied on Tobit and weighted least-squares analysis to examine the determinants of hospital mean length of stay and transfer rates to skilled and intermediate care homes for selected diagnosis-related groups (DRGs) with high levels of postacute service use. Hospitals in low bed supply areas were found to have proportionately fewer nursing home transfers and longer mean lengths of stay. Having swing beds or a long-term care unit led to speedier discharges and higher skilled nursing facility (SNF) transfers, especially for patients with hip or femur procedures or major joint and limb reattachment procedures (DRGs 209 and 210). The results suggest that Medicare should consider compensating hospitals for back-up days and that bundled payment experiments could reduce current inequities resulting from differential access to nursing home care

Business · Incentive · Nurse education · Nursing shortage · Payment · Prospective payment system · Skilled Nursing Facility · Emergency Medicine · Finance · Geriatric Care and Nursing Homes · Global Health Care Issues · Healthcare Policy and Management · Medicine · Nursing

  • The Regulatory Environment and Rural Hospital Long‐Term Care Strategies From 1997 to 2003

    Open Access•Mary L Fennell, Susan Campbell et al.•The Journal of Rural Health•2007

  • Transitions Through Postacute and Long-Term Care Settings

    Christopher M Murtaugh, Ann Litke•Medical Care•2002

  • Estimation of Relationships for Limited Dependent Variables

    James Tobin•Econometrica•1958

  • Limited-dependent and qualitative variables in econometrics

    G S Maddala•Limited-Dependent and Qualitative…•1983

  • The Uses of Tobit Analysis

    John F Mcdonald, Robert Moffitt et al.•The Review of Economics and…•1980

  • Medicare Prospective Payment and Posthospital Transfers to Subacute Care

    Michael A Morrisey, Frank A Sloan et al.•Medical Care•1988

Unique citing works2
Citations per year0,08
Citation span2002 - 2007 (6)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2
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