Do Hospital-Owned Skilled Nursing Facilities Provide Better Post-Acute Care Quality?

Momotazur Rahman, Edward Norton and David C. Grabowski

No 22515, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: As hospitals are increasingly held accountable for patients' post-discharge outcomes under new payment models, hospitals may choose to acquire skilled nursing facilities (SNFs) to better manage these outcomes. This raises the question of whether patients discharged to hospital-based SNFs have better outcomes. In unadjusted comparisons, hospital-based SNF patients have much lower Medicare utilization in the 180 days following discharge relative to freestanding SNF patients. We solved the problem of differential selection into hospital-based and freestanding SNFs by using differential distance from home to the nearest hospital with a SNF relative to the distance from home to the nearest hospital without a SNF as an instrument. We found that hospital-based SNF patients spent roughly 5 more days in the community and 6 fewer days in the SNF in the 180 days following their original hospital discharge with no significant effect on mortality or hospital readmission.

JEL-codes: I11 I18 (search for similar items in EconPapers)
Date: 2016-08
New Economics Papers: this item is included in nep-hea
Note: AG EH
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Citations: View citations in EconPapers (12)

Published as Momotazur Rahman & Edward C. Norton & David C. Grabowski, 2016. "Do hospital-owned skilled nursing facilities provide better post-acute care quality?," Journal of Health Economics, .

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Journal Article: Do hospital-owned skilled nursing facilities provide better post-acute care quality? (2016)
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