The Impact of Hospital-Acquired Conditions on Medicare Program Payments

Kandilov, Amy; Coomer, Nicole; Dalton, Kathleen

doi:10.5600/mmrr.004.04.a01

Cited by 44 publications

(42 citation statements)

References 6 publications

(6 reference statements)

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“…Other government-funded studies examined Medicare payments, but not mortality, and found consistently higher episode payments for cases treated at LTCHs than those treated in other settings, although these studies do not adjust for selection bias due to unobservable characteristics 23,24. In contrast, we used an instrumental variable technique as a way to establish the causal effects of receiving care in an LTCH on patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

The Role of Long-term Acute Care Hospitals in Treating the Critically Ill and Medically Complex

et al. 2015

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Section: Discussionmentioning

confidence: 99%

The Role of Long-term Acute Care Hospitals in Treating the Critically Ill and Medically Complex

et al. 2015

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“…Each item can be scored on a scale of 1 to 4 or, in the case of friction/shear, 1 to 3 . A score ≤18 on the Braden scale score was used to categorise people as being at‐risk …”

Section: Methodsmentioning

confidence: 99%

“…A PU is “a localized injury to the skin and/or the underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear.” PUs cause considerable patient suffering from pain, affect the patient's quality of life emotionally, physically, and socially, and even put patients at increased risk of death . In addition, PUs lead to an economic burden on health care systems …”

Section: Introductionmentioning

confidence: 99%

The prevalence of pressure ulcers in community‐dwelling older adults: A study in an Indonesian city

Sari

Everink

Sari

et al. 2019

International Wound Journal

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The objectives of this study were to investigate the prevalence and the characteristics of pressure ulcers (PU) in community‐dwelling older adults in Indonesia, including specific characteristics of the PU patients and their use of formal and informal care. A cross‐sectional design was used for the study, with 325 participants aged 60 years or older, randomly chosen from the general community. The overall PU prevalence and the PU prevalence excluding category 1 were 10.8% (95% confidence interval [CI], 5.8‐15.8) and 5.2% (95% CI 0.2‐10.2), respectively. Category 1 PUs were mostly (34.3%) located on knees and toes, while category 2 and higher PUs were mostly (70.4%) located on the shoulder, sacrum, and hip. The main factors that contributed strongly to PUs among older adults in the community were the degree of physical activity, problems with sensory perception, and having a history of stroke. None of the participants with a PU received wound care or information about PUs from formal caregivers and only 11.4% received wound care from family caregivers. This study shows that pressure ulcers in community‐dwelling older adults in Indonesia are a relevant and largely unaddressed problem. Developing an intervention program to manage the PU problem in the community is recommended.

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“…They are also better equipped than other nurses to monitor for complications and adverse events 13,14 that increase readmission risk. 15 …”

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confidence: 99%

Hospitals With Higher Nurse Staffing Had Lower Odds Of Readmissions Penalties Than Hospitals With Lower Staffing

2013

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The Affordable Care Act’s Hospital Readmissions Reduction Program (HRRP) penalizes hospitals based on excess readmission rates among Medicare beneficiaries. The aim of the program is to reduce readmissions while aligning hospitals’ financial incentives with payers’ and patients’ quality goals. Many evidence-based interventions that reduce readmissions, such as discharge preparation, care coordination, and patient education, are grounded in the fundamentals of basic nursing care. Yet inadequate staffing can hinder nurses’ efforts to carry out these processes of care. We estimated the effect that nurse staffing had on the likelihood that a hospital was penalized under the HRRP. Hospitals with higher nurse staffing had 25 percent lower odds of being penalized compared to otherwise similar hospitals with lower staffing. Investment in nursing is a potential system-level intervention to reduce readmissions that policy makers and hospital administrators should consider in the new regulatory environment as they examine the quality of care delivered to US hospital patients.

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The Impact of Hospital-Acquired Conditions on Medicare Program Payments

Cited by 44 publications

References 6 publications

The Role of Long-term Acute Care Hospitals in Treating the Critically Ill and Medically Complex

The Role of Long-term Acute Care Hospitals in Treating the Critically Ill and Medically Complex

The prevalence of pressure ulcers in community‐dwelling older adults: A study in an Indonesian city

Hospitals With Higher Nurse Staffing Had Lower Odds Of Readmissions Penalties Than Hospitals With Lower Staffing

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