Strategic Patient Discharge: The Case of Long-Term Care Hospitals
| Autor: | Paul J. Eliason, James W. Roberts, Ryan C. McDevitt, Paul L. E. Grieco |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Patient discharge
Counterfactual thinking Economics and Econometrics 030503 health policy & services media_common.quotation_subject 05 social sciences Payment medicine.disease 03 medical and health sciences Long-term care Financial incentives 0502 economics and business medicine Operations management Prospective payment system Business Medical emergency 050207 economics 0305 other medical science health care economics and organizations media_common |
| Zdroj: | American Economic Review. 108:3232-3265 |
| ISSN: | 0002-8282 |
| DOI: | 10.1257/aer.20170092 |
| Popis: | Medicare’s prospective payment system for long-term acute-care hospitals (LTCHs) provides modest reimbursements at the beginning of a patient’s stay before jumping discontinuously to a large lump-sum payment after a prespecified number of days. We show that LTCHs respond to the financial incentives of this system by disproportionately discharging patients after they cross the large-payment threshold. We find this occurs more often at for-profit facilities, facilities acquired by leading LTCH chains, and facilities colocated with other hospitals. Using a dynamic structural model, we evaluate counterfactual payment policies that would provide substantial savings for Medicare. (JEL H51, I11, I13, I18) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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