Zimmerman Sheryl, Gruber-Baldini Ann L, Hebel J Richard, Burton Lynda, Boockvar Kenneth, Taler George, Quinn Charlene C, Magaziner Jay
Program on Aging, Disability and Long-Term Care, Cecil G. Sheps Center for Health Services Research and the School of Social Work, University of North Carolina at Chapel Hill, North Carolina 27514, USA.
Am J Alzheimers Dis Other Demen. 2008 Feb-Mar;23(1):57-65. doi: 10.1177/1533317507308778.
To evaluate the relationship of nursing home characteristics to Medicare costs overall and by dementia status.
New admissions followed for 2 years. Setting. Random stratified sample of 55 Maryland nursing homes.
Sample of 1257 residents.
Records, interview, and observation.
Medicare costs were lower in facilities that have a better environmental quality, hospice beds, and more food service workers; costs were higher in hospital-based facilities and those that have a higher Medicaid case mix, X-ray, and some specified types of staff. Across all characteristics, costs for residents with dementia were consistently two-thirds the cost of other residents.
In terms of dementia status, resident characteristics drive Medicare costs, as opposed to facility characteristics. Using alternative residential settings for individuals with dementia may increase Medicare costs of nursing home residents and Medicare costs of residents with dementia who are cared for in settings less able to attend to medical needs.
评估疗养院特征与医疗保险总体费用以及按痴呆症状态划分的费用之间的关系。
对新入院患者进行为期2年的跟踪。设置。从马里兰州55家疗养院中随机分层抽样。
1257名居民的样本。
记录、访谈和观察。
环境质量较好、设有临终关怀病床且食品服务人员较多的疗养院，医疗保险费用较低；以医院为基础的疗养院以及医疗补助病例组合较高、有X光设备和某些特定类型工作人员的疗养院，费用较高。在所有特征方面，患有痴呆症居民的费用始终是其他居民费用的三分之二。
就痴呆症状态而言，居民特征而非疗养院特征驱动医疗保险费用。为患有痴呆症的个人使用替代居住环境可能会增加疗养院居民的医疗保险费用以及在不太能满足医疗需求的环境中接受护理的痴呆症居民的医疗保险费用。
