Leibson C, Naessens J M, Krishan I, Campion M E, Ballard D
Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905.
Gerontologist. 1990 Jun;30(3):316-22. doi: 10.1093/geront/30.3.316.
This study examines whether shorter hospital stays following the introduction of Medicare's Prospective Payment System have been accompanied by increased mortality or an increased rate of discharge to nursing homes. An examination of hospitalizations for all elderly residents of Olmsted County, MN (N = 5,854) for 1980, 1985, and 1987 demonstrates significant increases in 60-day mortality and nursing home transfers after this system began. These increases, however, are largely explained by differences in risk factors other than length of stay, such as patient age, gender, disease severity, and complexity.
本研究探讨了医疗保险预期支付系统实施后住院时间缩短是否伴随着死亡率上升或转至疗养院的出院率增加。对明尼苏达州奥姆斯特德县所有老年居民(N = 5854)在1980年、1985年和1987年的住院情况进行检查发现,该系统实施后60天死亡率和转至疗养院的情况显著增加。然而,这些增加在很大程度上可由住院时间以外的风险因素差异来解释,如患者年龄、性别、疾病严重程度和复杂性。