Do Hospitals Participating in Accountable Care Organizations Discharge Patients to Higher Quality Nursing Homes?
| Autor: | Yihao Yuan, Rachel M. Werner, Amol S. Navathe, Alexander M. Bain |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Leadership and Management media_common.quotation_subject Assessment and Diagnosis Skilled Nursing Medicare Patient Readmission 03 medical and health sciences 0302 clinical medicine Nursing 030225 pediatrics Medicine Humans Quality (business) 030212 general & internal medicine Care Planning media_common Quality of Health Care Skilled Nursing Facilities Aged 80 and over Accountable Care Organizations business.industry Health Policy General Medicine Confidence interval Hospitals Patient Discharge United States Accountable care Fundamentals and skills Female Brief Reports Nursing homes business |
| Zdroj: | J Hosp Med |
| ISSN: | 1553-5606 |
| Popis: | We examined whether hospitals participating in Medicare's Shared Saving Program increased the use of highly rated skilled nursing facilities (SNFs) or decreased the use of low-rated SNFs hospital-wide after initiation of their accountable care organization (ACO) contracts compared with non-ACO hospitals. Using a difference-in-differences design, we estimated the change in the probability of discharge to 5-star and 1-star SNFs among all beneficiaries discharged from ACO-participating hospitals after the hospital initiated ACO participation. After joining an ACO, the percentage of hospital discharges going to a high-quality SNF increased by 3.4 percentage points on a base of 15.4% (95% confidence interval [CI] 1.3-5.5, P = .002) compared with non-ACO-participating hospitals. The probability of discharge from an ACO-participating hospital to low-quality SNFs did not change significantly compared with non-ACO-participating hospitals. Our findings indicate that ACO-participating hospitals were more likely to discharge patients to highly rated SNFs after they began their ACO contract but did not change the likelihood of discharge to lower rated SNFs in comparison with non-ACO hospitals. |
| Databáze: | OpenAIRE |
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