Weill Cornell Medical College, 425 East 61st Street, Suite 301, New York, NY, 10065.
Health Serv Res. 2013 Oct;48(5):1617-33. doi: 10.1111/1475-6773.12054. Epub 2013 Mar 23.
To evaluate the effect of Medicaid bed-hold policies on hospitalization of long-stay nursing home residents.
A nationwide random sample of long-stay nursing home residents with data elements from Medicare claims and enrollment files, the Minimum Data Set, the Online Survey Certification and Reporting System, and Area Resource File. The sample consisted of 22,200,089 person-quarters from 754,592 individuals who became long-stay residents in 17,149 nursing homes over the period beginning January 1, 2000 through December 31, 2005.
Linear regression models using a pre/post design adjusted for resident, nursing home, market, and state characteristics. Nursing home and year-quarter fixed effects were included to control for time-invariant facility influences and temporal trends associated with hospitalization of long-stay residents.
Adoption of a Medicaid bed-hold policy was associated with an absolute increase of 0.493 percentage points (95% CI: 0.039-0.946) in hospitalizations of long-stay nursing home residents, representing a 3.883 percent relative increase over the baseline mean.
Medicaid bed-hold policies may increase the likelihood of hospitalization of long-stay nursing home residents and increase costs for the federal Medicare program.
评估医疗补助床位保留政策对长期护理养老院居民住院的影响。
一项全国范围内的长期护理养老院居民随机抽样调查，数据来自医疗保险索赔和登记文件、最低数据集、在线调查认证和报告系统以及区域资源文件。该样本包括 2000 年 1 月 1 日至 2005 年 12 月 31 日期间在 17149 家养老院成为长期居民的 754592 个人的 22200089 人季度。
采用预/后设计的线性回归模型，调整了居民、养老院、市场和州特征。包括养老院和年份季度固定效应，以控制与长期居民住院相关的设施不变影响和时间趋势。
医疗补助床位保留政策的采用与长期护理养老院居民住院的绝对增加 0.493 个百分点（95%置信区间：0.039-0.946）相关，相对于基线平均值，相对增加了 3.883%。
医疗补助床位保留政策可能会增加长期护理养老院居民住院的可能性，并增加联邦医疗保险计划的成本。
