Health Care Service Use Among Elderly Seasonal Migrators
| Autor: | Julian Wolfson, Sarah K. Meier, Robert L. Kane, Molly M. Jeffery, Bryan E. Dowd, Jean M. Abraham |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Leadership and Management
Population Health care service Service use Primary care Medicare Residence Characteristics Payment models Health care Humans Medicine education health care economics and organizations Aged education.field_of_study Primary Health Care business.industry Health Policy Public Health Environmental and Occupational Health Medicare beneficiary Emergency department United States Seasons Emergency Service Hospital business Administrative Claims Healthcare Travel Medicine Demography |
| Zdroj: | Population Health Management. 21:415-421 |
| ISSN: | 1942-7905 1942-7891 |
| DOI: | 10.1089/pop.2017.0155 |
| Popis: | Elderly seasonal migrators share time between homes in different states, presenting challenges for care coordination and patient attribution methods. Medicare has prioritized alternative payment models, putting health care providers at risk for quality and value of services delivered to their attributed patients, regardless of the location of care. Little research is available to guide providers and payers on the service use of seasonal migrators. The authors use claims data on fee-for-service (FFS) Medicare beneficiaries' locations throughout the year to (1) identify seasonal migrators and (2) describe the care they receive in each seasonal home, focusing on primary care and emergency department (ED) visits and the relationships between the two. In all, 5.5% of the Medicare aged FFS population were identified as seasonal migrators, with 4.1% following the traditional snowbird pattern of migration, spending warm months in the north and cold months in the south. Migrators had higher rates of ED visits and primary care treatable (PCT) ED visits than the nonmigratory groups, controlling for location, age, race, sex, Medicaid status, season, and comorbidities. They also had more visits with specialist physicians, more days with outpatient services, and more days seeing a physician in any setting. Having local primary care strongly reduced rates of both PCT ED visits and total ED visits for all migration categories, with the greatest reduction seen in PCT ED visits by migrators (local primary care was associated with a 58% reduction in PCT ED visits by snowbirds and a 65% reduction in PCT ED visits by other migrators). |
| Databáze: | OpenAIRE |
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