The health effects of nursing home specialization in post-acute care

IF 3.4 2区 经济学 Q1 ECONOMICS
Zachary S. Templeton , Nate C. Apathy , R. Tamara Konetzka , Meghan M. Skira , Rachel M. Werner
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引用次数: 0

Abstract

Nursing homes serve both long-term care and post-acute care (PAC) patients, two groups with distinct financing mechanisms and requirements for care. We examine empirically the effect of nursing home specialization in PAC using 2011–2018 data for Medicare patients admitted to nursing homes following a hospital stay. To address patient selection into specialized nursing homes, we use an instrumental variables approach that exploits variation over time in the distance from the patient's residential ZIP code to the closest nursing home with different levels of PAC specialization. We find that patients admitted to nursing homes more specialized in PAC have lower hospital readmissions and mortality, longer nursing home stays, and higher Medicare spending for the episode of care, suggesting that specialization improves patient outcomes but at higher costs.

疗养院在急性后护理中的专业化对健康的影响。
疗养院为长期护理和急性期后护理(PAC)患者提供服务,这两个群体有着不同的融资机制和护理要求。我们使用2011-2018年住院后入住疗养院的医疗保险患者的数据,实证检验了疗养院专业化对PAC的影响。为了解决患者选择进入专业疗养院的问题,我们使用了一种工具变量方法,该方法利用了从患者居住的邮政编码到最近的具有不同PAC专业水平的疗养院的距离随时间的变化。我们发现,入住PAC更专业的疗养院的患者的住院率和死亡率更低,在疗养院停留的时间更长,医疗保险的支出也更高,这表明专业化可以改善患者的预后,但成本更高。
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来源期刊
Journal of Health Economics
Journal of Health Economics 医学-卫生保健
CiteScore
6.10
自引率
2.90%
发文量
96
审稿时长
49 days
期刊介绍: This journal seeks articles related to the economics of health and medical care. Its scope will include the following topics: Production and supply of health services; Demand and utilization of health services; Financing of health services; Determinants of health, including investments in health and risky health behaviors; Economic consequences of ill-health; Behavioral models of demanders, suppliers and other health care agencies; Evaluation of policy interventions that yield economic insights; Efficiency and distributional aspects of health policy; and such other topics as the Editors may deem appropriate.
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