Health services research
-
Health services research · Feb 2015
What is the value of adding Medicare data in estimating VA hospital readmission rates?
To determine the effects of including diagnostic and utilization data from a secondary payer on readmission rates and hospital profiles. ⋯ Inclusion of secondary payer data may cause changes in hospital profiles, depending on the methodology used. An assessment of readmission rates should include, to the extent possible, all available information about patients' utilization of care.
-
Health services research · Feb 2015
Observational StudyTotal cost of care lower among Medicare fee-for-service beneficiaries receiving care from patient-centered medical homes.
To compare health care utilization and payments between NCQA-recognized patient-centered medical home (PCMH) practices and practices without such recognition. ⋯ This study provides additional evidence about the potential of the PCMH model for reducing health care utilization and the cost of care.
-
Health services research · Feb 2015
Higher Medicare SNF care utilization by dual-eligible beneficiaries: can Medicaid long-term care policies be the answer?
To examine outcomes associated with dual eligibility (Medicare and Medicaid) of patients who are admitted to skilled nursing facility (SNF) care and whether differences in outcomes are related to states' Medicaid long-term care policies. ⋯ Dual eligibles utilize more SNF care and experience higher survival rates than comparable Medicare-only patients. Higher HCBS spending may reduce the longer SNF length of stay of dual eligibles without increasing mortality and may save money for both Medicare and Medicaid.
-
Health services research · Feb 2015
Comparative StudySurge capacity: analysis of census fluctuations to estimate the number of intensive care unit beds needed.
To compare methods of characterizing intensive care unit (ICU) bed use and estimate the number of beds needed. ⋯ Compared to using yearly averages, analyzing day-to-day fluctuations in patient census gives a more accurate picture of ICU bed use. Failing to provide adequate "surge capacity" can lead to demand that frequently and severely exceeds supply.
-
Health services research · Feb 2015
The early effects of Medicare's mandatory hospital pay-for-performance program.
To evaluate the impact of hospital value-based purchasing (HVBP) on clinical quality and patient experience during its initial implementation period (July 2011-March 2012). ⋯ The timing of the financial incentives in HVBP was not associated with improved quality of care. It is unclear whether improvement for the clinical process measures prior to the start of HVBP was driven by the expectation of the program or was the result of other factors.