Laliberte L, Mor V, Berg K, Intrator O, Calore K, Hiris J
Brown University Center for Gerontology and Health Care Research, Providence, RI 02912, USA.
Milbank Q. 1997;75(2):203-33. doi: 10.1111/1468-0009.00052.
The Medicare Catastrophic Coverage Act (MCCA) of 1988 altered eligibility and coverage for skilled nursing facility (SNF) care and changed Medicaid eligibility rules for nursing-home residents. Detailed data on the residents of a for-profit nursing-home chain and Medicare claims for a 1 percent sample of beneficiaries were used to examine the impact of the MCCA on nursing homes. The case mix of nursing-home admissions was scrutinized, specifically for length of stay, discharge disposition, rate of hospitalization, and changes in payer source. Findings revealed that, although the proportion of Medicare-financed nursing-home care increased, as did the case-mix severity of residents during the MCCA period, there was no corollary reduction in hospital use by nursing-home residents.
1988年的《医疗保险灾难性保险法案》（MCCA）改变了熟练护理设施（SNF）护理的资格和覆盖范围，并更改了疗养院居民的医疗补助资格规则。利用一家营利性连锁疗养院居民的详细数据以及1%受益人的医疗保险索赔数据，来研究MCCA对疗养院的影响。仔细审查了疗养院入院患者的病例组合，特别是住院时间、出院处置、住院率以及支付方来源的变化。研究结果显示，尽管在MCCA期间，由医疗保险资助的疗养院护理比例有所增加，居民的病例组合严重程度也有所增加，但疗养院居民的住院率并没有相应下降。
