The contributions of survey‐based versus administrative measures of socioeconomic status in predicting type of post‐acute care for hospitalized Medicare beneficiaries

2021 ◽  
Author(s):  
Ye Zhu ◽  
Sally C. Stearns ◽  
George M. Holmes
Keyword(s):  
Socioeconomic Status ◽  
Acute Care ◽  
Medicare Beneficiaries ◽  
Post Acute Care

scholarly journals Post-acute care use patterns among Hospital Service Areas by older adults in the United States: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julianna M. Dean ◽  
Kimberly Hreha ◽  
Ickpyo Hong ◽  
Chih-Ying Li ◽  
Daniel Jupiter ◽  
...  
Keyword(s):  
Acute Care ◽  
Care Service ◽  
Inpatient Rehabilitation ◽  
The United States ◽  
Service Area ◽  
Hospital Service ◽  
Medicare Beneficiaries ◽  
Skilled Nursing ◽  
Service Areas ◽  
Post Acute Care

Abstract Background Despite the success of stroke rehabilitation services, differences in service utilization exist. Some patients with stroke may travel across regions to receive necessary care prescribed by their physician. It is unknown how availability and combinations of post-acute care facilities in local healthcare markets influence use patterns. We present the distribution of skilled nursing, inpatient rehabilitation, and long-term care hospital services across Hospital Service Areas among a national stroke cohort, and we describe drivers of post-acute care service use. Methods We extracted data from 2013 to 2014 of a national stroke cohort using Medicare beneficiaries (174,498 total records across 3232 Hospital Service Areas). Patients’ ZIP code of residence was linked to the facility ZIP code where care was received. If the patient did not live in the Hospital Service Area where they received care, they were considered a “traveler”. We performed multivariable logistic regression to regress traveling status on the care combinations available where the patient lived. Results Although 73.4% of all Hospital Service Areas were skilled nursing-only, only 23.5% of all patients received care in skilled nursing-only Hospital Service Areas; 40.8% of all patients received care in Hospital Service Areas with only inpatient rehabilitation and skilled nursing, which represented only 18.2% of all Hospital Service Areas. Thirty-five percent of patients traveled to a different Hospital Service Area from where they lived. Regarding “travelers,” for those living in a skilled nursing-only Hospital Service Area, 49.9% traveled for care to Hospital Service Areas with only inpatient rehabilitation and skilled nursing. Patients living in skilled nursing-only Hospital Service Areas had more than five times higher odds of traveling compared to those living in Hospital Service Areas with all three facilities. Conclusions Geographically, the vast majority of Hospital Service Areas in the United States that provided rehabilitation services for stroke survivors were skilled nursing-only. However, only about one-third lived in skilled nursing-only Hospital Service Areas; over 35% traveled to receive care. Geographic variation exists in post-acute care; this study provides a foundation to better quantify its drivers. This study presents previously undescribed drivers of variation in post-acute care service utilization among Medicare beneficiaries—the “traveler effect”.

scholarly journals Utilization of Post-Acute Care Following Distal Radius Fracture Among Medicare Beneficiaries

2015 ◽  
Vol 40 (12) ◽  
pp. 2401-2409.e8 ◽  
Author(s):  
Lin Zhong ◽  
Elham Mahmoudi ◽  
Aviram M. Giladi ◽  
Melissa Shauver ◽  
Kevin C. Chung ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Acute Care ◽  
Distal Radius ◽  
Radius Fracture ◽  
Medicare Beneficiaries ◽  
Post Acute Care

scholarly journals Trends in Post–Acute Care Use Among Medicare Beneficiaries: 2000 to 2015

JAMA ◽  
2018 ◽  
Vol 319 (15) ◽  
pp. 1616 ◽  
Author(s):  
Rachel M. Werner ◽  
R. Tamara Konetzka
Keyword(s):  
Acute Care ◽  
Medicare Beneficiaries ◽  
Post Acute Care

Co-Calibrated Admission Functional Score and Subsequent Post-Acute Care Utilization for Medicare Beneficiaries

2018 ◽  
Vol 99 (10) ◽  
pp. e65
Author(s):  
Chih-Ying (Cynthia) Li ◽  
Amol Karmarkar ◽  
Allen Haas ◽  
Yong-Fang Kuo ◽  
Kenneth Ottenbacher
Keyword(s):  
Acute Care ◽  
Care Utilization ◽  
Functional Score ◽  
Medicare Beneficiaries ◽  
Acute Care Utilization ◽  
Post Acute Care

Abstract 15072: Thirty Day Episode of Care Spending Following Heart Failure Hospitalization Among Medicare Beneficiaries With Heart Failure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nihar R Desai ◽  
Craig Parzynski ◽  
Ralph J Riello ◽  
Phil Sarocco ◽  
Tariq Ahmad
Keyword(s):  
Heart Failure ◽  
Acute Care ◽  
Hypertensive Heart Disease ◽  
Administrative Claims ◽  
Medicare Beneficiaries ◽  
Index Hospitalization ◽  
Episode Of Care ◽  
The Impact ◽  
Over Time ◽  
Post Acute Care

Background: Heart failure (HF) is one of the costliest conditions in the US with immense public health interest to examine and improve the value of care. We sought to characterize current payments spanning the index hospitalization through 30-days post-discharge for Medicare beneficiaries with HF. Methods: Using Medicare fee-for-service administrative claims data, we identified patients hospitalized with HF from 2016-2018 with the following primary discharge diagnoses (ICD-10 codes): systolic HF (50.2 and 50.4), diastolic HF (50.3), hypertensive heart disease (HHD) with HF (I11), and HHD with HF and chronic kidney disease (CKD) (I13). Coding patterns over time across these four groups, mean 30-day episode of care spending overall, and proportion of total costs allocated to the index hospitalization and post-acute care were analyzed. Results: The study sample included 174,539 patients hospitalized with systolic HF; 163,071 diastolic HF; 221,820 HHD with HF; and 359,950 HHD with HF and CKD. Over time, there was a substantial increase in the use of the HHD with HF +/- CKD codes, accounting for 52% of HF hospitalizations in 2018 (Figure). We found substantial spending on 30-day episode for HF with nearly 2-fold variation across mean spending. Overall, 30-day episode spending was significantly higher for HHD with HF and CKD as compared to other diagnoses. Across all codes, the index hospitalization accounts for 70% of total episode spending while 30% is accounted for by post-acute care spending (Table). Conclusions: This patient episode-level analysis of contemporary Medicare beneficiaries suggests several areas to improve the value of HF care. The 30-day episode of care spending for heart failure hospitalizations is substantial with more than 2-fold variation. The impact of alternative payment models on HF outcomes and spending remains an important area for ongoing investigation.

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