Bishop C E, Dubay L C
Bigel Institute for Health Policy, Brandeis University, Waltham, MA 02254-9110.
Inquiry. 1991 Winter;28(4):345-56.
The willingness of nursing homes to accept any Medicare admissions (Medicare participation) and the number of patients they serve (Medicare utilization) affect the access of Medicare SNF patients to posthospital care. Characteristics of facilities, their market areas, and state Medicaid reimbursement were found to affect both participation and utilization. Most important, when Medicaid and private nursing home market conditions support high-intensity care, facilities are more likely to serve Medicare patients and admit more of them. SNFs in states that require Medicare certification are more likely to accept Medicare admissions, suggesting that the cost and effort of achieving certification are a barrier to service to Medicare SNF patients. For-profit facilities, hospital-based SNFs, and larger nursing homes have higher rates of participation and serve more Medicare patients when they serve any.
疗养院接受任何医疗保险患者入院治疗的意愿（医疗保险参与度）以及它们所服务的患者数量（医疗保险利用率）会影响医疗保险熟练护理机构（SNF）的患者获得院后护理的机会。研究发现，机构的特征、其市场区域以及州医疗补助报销情况会影响参与度和利用率。最重要的是，当医疗补助和私立疗养院的市场状况支持高强度护理时，机构更有可能为医疗保险患者提供服务并接纳更多此类患者。要求获得医疗保险认证的州的SNF更有可能接受医疗保险患者入院，这表明获得认证的成本和努力是为医疗保险SNF患者提供服务的一个障碍。营利性机构、医院附属的SNF以及规模较大的疗养院参与度更高，并且在提供服务时会接纳更多医疗保险患者。
