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医疗保险的预期支付系统是否导致住院时间缩短?

Did Medicare's prospective payment system cause length of stay to fall?

作者信息

Newhouse J P, Byrne D J

出版信息

J Health Econ. 1988 Dec;7(4):413-6. doi: 10.1016/0167-6296(88)90023-9.

Abstract

It is well accepted that the Medicare Payment System caused average length of stay in United States hospitals to fall, but these calculations have been based on patients in short-stay, acute care hospitals. If one considers all patients covered by Medicare, length of stay rose between 1981 and 1984, although the 1985 value was below the 1981 value. The proximate cause was a marked increase in the proportion of patients staying more than 60 days in the hospital. The data are consistent with a shift of such patients from short-stay, acute care hospitals to other, exempt hospitals and units.

摘要

医疗保险支付系统致使美国医院的平均住院时长下降,这一点已得到广泛认可,但这些计算是基于短期急性护理医院的患者得出的。如果将所有医疗保险覆盖的患者考虑在内,1981年至1984年间住院时长有所上升,尽管1985年的值低于1981年的值。直接原因是住院超过60天的患者比例显著增加。这些数据与这类患者从短期急性护理医院转移至其他豁免医院和科室的情况相符。

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