{"title":"Correction to “Changes in Skilled Nursing and Home Health Admissions Associated With Medicare Payment Reforms and the COVID-19 Pandemic”","authors":"","doi":"10.1111/jgs.19531","DOIUrl":null,"url":null,"abstract":"<p>R. A. Prusynski, N. E. Leland, A. Humbert, A. Dahal, C. Brown, H. Amaravadi, D. Saliba, T. M. Mroz, “Changes in Skilled Nursing and Home Health Admissions Associated With Medicare Payment Reforms and the COVID-19 Pandemic,” <i>Journal of the American Geriatrics Society</i> 73, no. 2 (2025): 592–601, https://doi.org/10.1111/jgs.19322.</p><p>The authors have noticed that some inpatient rehabilitation stays were not removed from the hospital cohort. This requires a change to all descriptive statistics and analytic results.</p><p>\n <b>Abstract</b>\n </p><p>\n <b>Methods:</b> Using 100% of Medicare fee-for-service data, we conducted adjusted interrupted time series analyses of 30,507,466 hospital stays.</p><p>\n <b>Results:</b> At baseline, an average 18.3% of hospitalized beneficiaries were admitted to SNFs and 14.2% to HHAs. Post-COVID, admissions to SNF declined to 15.8% of patients being discharged from hospitals and HHA admissions increased to 18.6%.</p><p>\n <b>RESULTS</b>\n </p><p>Our sample included 30,507,466 Medicare fee-for-service acute hospital stays between January 2018 and October 2021. Of the 785,626 average monthly hospital discharges during the baseline period, 18.3% were admitted to SNF within 3 days and 14.2% were admitted to HHA within 14 days (Figure 1). During the COVID-19 period, SNF admissions decreased to an average of 15.8% and HHA admissions increased to 18.6%. PDPM implementation in October 2019 was associated with an immediate 0.29 pp decline in SNF admissions (95% CI −0.43, −0.16). However, the negative baseline trend reversed, resulting in 0.36 pp more SNF admissions per month after PDPM compared to baseline trends, for a 0.43pp-increase in SNF admissions by the end of Period 2 compared to the projected rate based on pre-PDPM trends.</p><p>COVID-19 was associated with an immediate 2.89 pp reduction in SNF admissions (95% CI −3.08, −2.69) compared to the baseline projected rate, and was not significantly associated with any trend changes in SNF admissions.</p><p>For HHA admissions, the baseline trend was an adjusted monthly increase of 0.04 pp (95% CI 0.01, 0.06). PDPM was significantly associated with a 0.34 pp immediate decline (95% CI −0.49, −0.18) and a 0.38 pp monthly decline in HHA admissions, for a total 1.01 pp reduction in HHA admissions by the end of Period 2 compared to the baseline projection. There was no immediate change in HHA admissions the month after PDGM implementation. However, PDGM was associated with a 1.10 pp monthly increase in HHA admissions compared to baseline, for a total 0.90 pp higher rate at the end of Period 3 compared to the projection from baseline. COVID-19 was associated with an immediate 3.66 pp increase in HHA admissions (95% CI 3.42, 3.99) but was not significantly associated with any trend changes compared to baseline projections.</p><p>\n <b>Tables</b>\n </p><p>In the revised Table 1, all descriptive statistics were recalculated using the smaller cohort.</p><p>In the revised Table 2, all coefficients, confidence intervals, and <i>p</i>-value statistics now reflect results of the analysis using the smaller cohort.</p><p>Figure 1 has been recreated using the smaller cohort.</p><p>We apologize for these errors.</p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1992-1998"},"PeriodicalIF":4.5000,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19531","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Geriatrics Society","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jgs.19531","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
引用次数: 0
R. A. Prusynski, N. E. Leland, A. Humbert, A. Dahal, C. Brown, H. Amaravadi, D. Saliba, T. M. Mroz, “Changes in Skilled Nursing and Home Health Admissions Associated With Medicare Payment Reforms and the COVID-19 Pandemic,” Journal of the American Geriatrics Society 73, no. 2 (2025): 592–601, https://doi.org/10.1111/jgs.19322.
The authors have noticed that some inpatient rehabilitation stays were not removed from the hospital cohort. This requires a change to all descriptive statistics and analytic results.
Abstract
Methods: Using 100% of Medicare fee-for-service data, we conducted adjusted interrupted time series analyses of 30,507,466 hospital stays.
Results: At baseline, an average 18.3% of hospitalized beneficiaries were admitted to SNFs and 14.2% to HHAs. Post-COVID, admissions to SNF declined to 15.8% of patients being discharged from hospitals and HHA admissions increased to 18.6%.
RESULTS
Our sample included 30,507,466 Medicare fee-for-service acute hospital stays between January 2018 and October 2021. Of the 785,626 average monthly hospital discharges during the baseline period, 18.3% were admitted to SNF within 3 days and 14.2% were admitted to HHA within 14 days (Figure 1). During the COVID-19 period, SNF admissions decreased to an average of 15.8% and HHA admissions increased to 18.6%. PDPM implementation in October 2019 was associated with an immediate 0.29 pp decline in SNF admissions (95% CI −0.43, −0.16). However, the negative baseline trend reversed, resulting in 0.36 pp more SNF admissions per month after PDPM compared to baseline trends, for a 0.43pp-increase in SNF admissions by the end of Period 2 compared to the projected rate based on pre-PDPM trends.
COVID-19 was associated with an immediate 2.89 pp reduction in SNF admissions (95% CI −3.08, −2.69) compared to the baseline projected rate, and was not significantly associated with any trend changes in SNF admissions.
For HHA admissions, the baseline trend was an adjusted monthly increase of 0.04 pp (95% CI 0.01, 0.06). PDPM was significantly associated with a 0.34 pp immediate decline (95% CI −0.49, −0.18) and a 0.38 pp monthly decline in HHA admissions, for a total 1.01 pp reduction in HHA admissions by the end of Period 2 compared to the baseline projection. There was no immediate change in HHA admissions the month after PDGM implementation. However, PDGM was associated with a 1.10 pp monthly increase in HHA admissions compared to baseline, for a total 0.90 pp higher rate at the end of Period 3 compared to the projection from baseline. COVID-19 was associated with an immediate 3.66 pp increase in HHA admissions (95% CI 3.42, 3.99) but was not significantly associated with any trend changes compared to baseline projections.
Tables
In the revised Table 1, all descriptive statistics were recalculated using the smaller cohort.
In the revised Table 2, all coefficients, confidence intervals, and p-value statistics now reflect results of the analysis using the smaller cohort.
Figure 1 has been recreated using the smaller cohort.
R. A. Prusynski， N. E. Leland， A. Humbert， A. Dahal， C. Brown， H. Amaravadi， D. Saliba， T. M. Mroz，“与医疗保险支付改革和COVID-19大流行相关的熟练护理和家庭健康入院的变化”，美国老年医学会杂志，第73期。2 (2025): 592-601, https://doi.org/10.1111/jgs.19322.The作者注意到一些住院康复期未从医院队列中移除。这需要对所有描述性统计和分析结果进行更改。方法：采用100%的医疗保险服务收费数据，对30,507,466例住院患者进行调整后的中断时间序列分析。结果：在基线时，平均18.3%的住院受益人被送入snf， 14.2%的住院受益人被送入hha。新冠肺炎后，SNF入院率下降至15.8%，HHA入院率上升至18.6%。结果：我们的样本包括2018年1月至2021年10月期间30,507,466名医疗保险按服务收费的急性住院患者。在基线期间的785,626名平均每月出院患者中，18.3%在3天内入住SNF， 14.2%在14天内入住HHA（图1）。在新冠肺炎期间，SNF的平均入学率下降到15.8%，HHA的入学率上升到18.6%。2019年10月实施PDPM与SNF入院率立即下降0.29个百分点相关（95% CI - 0.43, - 0.16）。然而，负基线趋势逆转，与基线趋势相比，PDPM后每月SNF入学率增加了0.36个百分点，与基于PDPM前趋势的预测率相比，第二阶段结束时SNF入学率增加了0.43个百分点。与基线预测率相比，COVID-19与SNF入院率立即降低2.89个百分点（95% CI - 3.08, - 2.69）相关，且与SNF入院率的任何趋势变化无显著相关性。对于HHA入院，基线趋势是调整后每月增加0.04个百分点（95% CI 0.01, 0.06）。PDPM与HHA入院人数立即下降0.34个百分点（95% CI - 0.49, - 0.18）和每月下降0.38个百分点显著相关，与基线预测相比，第2期结束时HHA入院人数共减少1.01个百分点。PDGM实施一个月后，HHA的入院情况没有立即发生变化。然而，与基线相比，PDGM与HHA入院人数每月增加1.10个百分点有关，在第3期结束时，与基线预测相比，总共增加了0.90个百分点。与基线预测相比，COVID-19与HHA入院率立即增加3.66 pp相关（95% CI 3.42, 3.99），但与任何趋势变化无显著相关。在修订后的表1中，使用较小的队列重新计算所有描述性统计数据。在修订后的表2中，所有系数、置信区间和p值统计量现在都反映了使用较小队列的分析结果。图1是使用较小的队列重新创建的。我们为这些错误道歉。
期刊介绍：
Journal of the American Geriatrics Society (JAGS) is the go-to journal for clinical aging research. We provide a diverse, interprofessional community of healthcare professionals with the latest insights on geriatrics education, clinical practice, and public policy—all supporting the high-quality, person-centered care essential to our well-being as we age. Since the publication of our first edition in 1953, JAGS has remained one of the oldest and most impactful journals dedicated exclusively to gerontology and geriatrics.
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