The initial effects of the prospective payment system on nursing home patients

M.A. Lewis, B. Leake, M. Leal-Sotelo and V. Clark

American Journal of Public Health, 1987, vol. 77, issue 7, 819-821

Abstract: We examined the discharge outcomes and admission characteristics of patients admitted to Southern California skilled nursing facilities (SNFs) for the first time following an episode of hospitalization in 1980, 1982-83 (all pre-prospective payment system), and all admissions during July through September 1984 (post-prospective payment). The proportion of patients covered by Medicare on admission was 18 per cent in 1980, 36 per cent in 1982-83, and 57 per cent in 1984. For patients discharged within 30-60 days to SNFs, in all three time periods more Medicare than non-Medicare patients were bed-bound, had indwelling catheters, and were comatose. There were only modest case-mix differences between the groups and no changes over time in discharge outcomes, including the proportion dying in the SNF, or being returned to a hospital. The time-related changes that were found preceded the implementation of the diagnosis related group (DRG) based prospective payment system.

Date: 1987
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:1987:77:7:819-821_5

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