Dual eligibility, selection of skilled nursing facility, and length of Medicare paid postacute stay

Medical Care Research and Review

Volumn 71, Issue 4, 2014, Pages 384-401

  Rahman, Momotazur ^a   Gozalo, Pedro ^a   Tyler, Denise ^a   Grabowski, David C ^b   Trivedi, Amal ^a   Mor, Vincent ^a  

^a BROWN UNIVERSITY   (United States)

^b HARVARD UNIVERSITY   (United States)

Author keywords

care utilization; dual eligibility; skilled nursing facility care

Indexed keywords

AGED; ALZHEIMER DISEASE; ARTICLE; BIPOLAR DISORDER; CEREBROVASCULAR ACCIDENT; CHARLSON COMORBIDITY INDEX; COMORBIDITY; CONCEPTUAL FRAMEWORK; CONGESTIVE HEART FAILURE; CONTROLLED STUDY; DAILY LIFE ACTIVITY; DEMENTIA; DIABETES MELLITUS; ELIXHAUSER COMORBIDITY INDEX; EMPHYSEMA; FEMALE; HEALTH CARE UTILIZATION; HEALTH INSURANCE ELIGIBILITY; HEALTH STATUS; HIP FRACTURE; HOSPITAL ADMISSION; HOSPITAL DISCHARGE; HOSPITAL READMISSION; HOSPITALIZATION; HUMAN; HYPOTHESIS; INTENSIVE CARE; LENGTH OF STAY; LOWEST INCOME GROUP; MAJOR CLINICAL STUDY; MALE; MALIGNANT NEOPLASTIC DISEASE; MARRIED PERSON; MEDICAID; MEDICARE; NURSE PATIENT RATIO; NURSING CARE; NURSING HOME; NURSING HOME PATIENT; NURSING STAFF; PATIENT REFERRAL; POVERTY; REGISTERED NURSE; SAMPLE SIZE; SCHIZOPHRENIA; DUAL ELIGIBILITY (HEALTH INSURANCE); ECONOMICS; HEALTH CARE COST; ORGANIZATION AND MANAGEMENT; STATISTICS AND NUMERICAL DATA; UNITED STATES;

AGED; DUAL MEDICAID MEDICARE ELIGIBILITY; ELIGIBILITY DETERMINATION; FEMALE; HEALTH CARE COSTS; HUMANS; LENGTH OF STAY; MALE; MEDICAID; MEDICARE; REFERRAL AND CONSULTATION; SKILLED NURSING FACILITIES; UNITED STATES;

EID: 84903825221     PISSN: 10775587     EISSN: 15526801     Source Type: Journal    
DOI: 10.1177/1077558714533824     Document Type: Article

References (41)

1. Agency for Health Care Administration. (2013). Uncompensated care: Medicare bad debt coverage to skilled nursing facility: A critical lifeline (Issue Brief). Retrieved from http://www.ahcancal.org/research-data/funding/ Documents/bad%20debt%20issue%20brief.pdf
2. Backhaus R., Verbeek H., van Rossum E., Capezuti E., Hamers J. P. Nurse staffing impact on quality of care in nursing homes: A systematic review of longitudinal studies [Review]. Journal of the American Medical Directors Association. 2014 ;:
3. Bostick J. E., Rantz M. J., Flesner M. K., Riggs C. J. Systematic review of studies of staffing and quality in nursing homes. Journal of the American Medical Directors Association. 2006 ; 7: 366-376
4. Brown R. S., Peikes D., Peterson G., Schore J., Razafindrakoto C. M. Six features of medicare coordinated care demonstration programs that cut hospital admissions of high-risk patients. Health Affairs (Millwood). 2012 ; 31: 1156-1166
5. Cai Q., Salmon J. W., Rodgers M. E. Factors associated with long-stay nursing home admissions among the U.S. elderly population: Comparison of logistic regression and the Cox proportional hazards model with policy implications for social work. Social Work in Health Care. 2009 ; 48: 154-168
6. Castle N. G. Nursing home caregiver staffing levels and quality of care. Journal of Applied Gerontology. 2008 ; 27: 375-405
7. Castle N. G., Anderson R. A. Caregiver staffing in nursing homes and their influence on quality of care: Using dynamic panel estimation methods. Medical Care. 2011 ; 49: 545-552
8. Deyo R. A., Cherkin D. C., Ciol M. A. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology. 1992 ; 45: 613-619
9. Elixhauser A., Steiner C., Harris D. R., Coffey R. M. Comorbidity measures for use with administrative data. Medical Care. 1998 ; 36: 8-27
10. Fries B. E., Cooney L. M. Resource utilization groups. A patient classification system for long-term care. Medical Care. 1985 ; 23: 110-122
11. Fries B. E., Schneider D. P., Foley W. J., Gavazzi M., Burke R., Cornelius E. Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG-III). Medical Care. 1994 ; 32: 668-685
12. Gold M. R., Jacobson G. A., Garfield R. L. There is little experience and limited data to support policy making on integrated care for dual eligibles. Health Affairs (Millwood). 2012 ; 31: 1176-1185
13. Grabowski D. C. Special Needs Plans and the coordination of benefits and services for dual eligibles. Health Affairs (Millwood). 2009 ; 28: 136-146
14. Grabowski D. C., Feng Z., Hirth R., Rahman M., Mor V. Effect of nursing home ownership on the quality of post-acute care: An instrumental variables approach. Journal of Health Economics. 2012 ; 32: 12-21
15. Harrington C., Kovner C., Mezey M., Kayser-Jones J., Burger S., Mohler M., Zimmerman D. Experts recommend minimum nurse staffing standards for nursing facilities in the United States. The Gerontologist. 2000 ; 40: 5-16
16. Harrington C., Zimmerman D., Karon S. L., Robinson J., Beutel P. Nursing home staffing and its relationship to deficiencies. Journals of Gerontology B Psychological Sciences & Social Sciences. 2000 ; 55: S278 - S287
17. Hawes C., Morris J. N., Phillips C. D., Mor V., Fries B. E., Nonemaker S. Reliability estimates for the Minimum Data Set for nursing home resident assessment and care screening (MDS). The Gerontologist. 1995 ; 35: 172-178
18. Howell S., Silberberg M., Quinn W. V., Lucas J. A. Determinants of remaining in the community after discharge: Results from New Jersey's Nursing Home Transition Program. The Gerontologist. 2007 ; 47: 535-547
19. Hyer K., Thomas K. S., Branch L., Harman J., Johnson C. E., Weech-Maldonado R. The influence of nurse staffing levels on quality of care in nursing homes. The Gerontologist. 2011 ; 51: 610-616
20. Intrator O., Hiris J., Berg K., Miller S. C., Mor V. The residential history file: Studying nursing home residents' long-term care histories. Health Services Research. 2011 ; 46 (1, Pt. 1). 120-137
21. Intrator O., Zinn J., Mor V. Nursing home characteristics and potentially preventable hospitalizations of long-stay residents. Journal of the American Geriatrics Society. 2004 ; 52: 1730-1736
22. Kelly A., Conell-Price J., Covinsky K., Cenzer I. S., Chang A., Boscardin W. J., Smith A. K. Length of stay for older adults residing in nursing homes at the end of life. Journal of the American Geriatrics Society. 2010 ; 58: 1701-1706
23. Kidder D., Rennison M., Goldberg H., Warner D., Bell B., Hadden L., Mor V. MegaQI covariate analysis and recommendations: Identification and evaluation of existing quality indicators that are appropriate for use in long-term care settings. Cambridge, MA: Abt Associates ; 2002 :
24. Lau D. T., Kasper J. D., Potter D. E., Lyles A., Bennett R. G. Hospitalization and death associated with potentially inappropriate medication prescriptions among elderly nursing home residents. Archives of Internal Medicine. 2005 ; 165: 68-74
25. Liu K., Doty P., Manton K. Medicaid spenddown in nursing homes. The Gerontologist. 1990 ; 30: 7-15
26. Martikainen P., Moustgaard H., Murphy M., Einio E. K., Koskinen S., Martelin T., Noro A. Gender, living arrangements, and social circumstances as determinants of entry into and exit from long-term institutional care at older ages: A 6-year follow-up study of older Finns. The Gerontologist. 2009 ; 49: 34-45
27. Medpac. (2012, June). A data book: Health care spending and the Medicare program. Retrieved from http://www.medpac.gov/documents/ Jun12DataBookEntireReport.pdf
28. Moon S., Shin J. Health care utilization among Medicare-Medicaid dual eligibles: A count data analysis. BMC Public Health. 2006a ; 6: 88
29. Moon S., Shin J. Racial differences in health care use among medicare only and dual eligibles. Journal of Health and Human Servvices Administration. 2006b ; 28: 326-345
30. Mor V. A comprehensive clinical assessment tool to inform policy and practice: Applications of the minimum data set. Medical Care. 2004 ; 42: III50 - III59
31. Mor V., Intrator O., Unruh M. A., Cai S. Temporal and geographic variation in the validity and internal consistency of the Nursing Home Resident Assessment Minimum Data Set 2.0. BMC Health Services Research. 2011 ; 11: 78
32. Morris J. N., Fries B. E., Mehr D. R., Hawes C., Phillips C., Mor V., Lipsitz L. A. MDS Cognitive Performance Scale. Journal of Gerontology. 1994 ; 49: M174 - M182
33. Morris J. N., Fries B. E., Morris S. A. Scaling ADLs within the MDS. Journals of Gerontology A Biological Sciences & Medical Sciences. 1999 ; 54: M546 - M553
34. Morris J. N., Hawes C., Fries B. E., Phillips C. D., Mor V., Katz S., Friedlob A. S. Designing the national resident assessment instrument for nursing homes. The Gerontologist. 1990 ; 30: 293-307
35. Health, United States, 2005. Hyattsville, MD: Author ; 2005 :
36. Newhouse J. P., Garber A. M. Geographic variation in health care spending in the United States: Insights from an Institute of Medicine report. JAMA. 2013 ; 310: 1227-1228
37. Phillips C. D., Morris J. N., Hawes C., Fries B. E., Mor V., Nennstiel M., Iannacchione V. Association of the Resident Assessment Instrument (RAI) with changes in function, cognition, and psychosocial status. Journal of American Geriatrics Society. 1997 ; 45: 986-993
38. Rahman M., Foster A. D., Grabowski D. C., Zinn J. S., Mor V. Effect of Hospital-SNF Referral Linkages on Rehospitalization. Health Services Research. 2013 ; 48 (6 Pt. 1). 1898-1919
39. Schnelle J. F., Simmons S. F., Harrington C., Cadogan M., Garcia E., Bates-Jensen B. M. Relationship of nursing home staffing to quality of care. Health Services Research. 2004 ; 39: 225-250
40. Shugarman L. R., Brown J. A. Nursing home selection: How do consumers choose? Volume I: Findings from focus groups of consumers and information intermediaries. Washington, DC: Office of Disability, Aging and Long-Term Care Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services ; 2006 :
41. Zwanziger J., Mukamel D. B., Indridason I. Use of resident-origin data to define nursing home market boundaries. Inquiry. 2002 ; 39: 56-66