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Nursing home hospitalizations often driven by payer status
Date:10/3/2011

The decision by nursing homes whether or not to treat an ill resident on-site or send them to a hospital are often linked to that person's insurance status. A new study out this month shows that on average individuals enrolled in Medicaid are 27 percent more likely to be sent to the hospital than individuals with private insurance decisions that often result in higher costs of care and poor health outcomes.

"Nursing homes have an incentive to hospitalize some residents more often than others," said Helena Temkin-Greener, Ph.D., M.P.H., senior author of the study and associate professor of Community and Preventive Medicine at the University of Rochester Medical Center. "This study provides strong evidence that these financial incentives may motivate consideration of payer source in the decision whether or not to hospitalize an individual."

While it has long been observed that Medicaid nursing home residents have higher hospitalization rates, it had been assumed this is because these residents are more likely to congregate in facilities with fewer resources to provide onsite care. A new study published in the journal Medical Care Research and Review for the first time looks at hospitalization rates within individual nursing homes to see if patients with Medicaid are treated differently from those with private insurance.

"Nursing homes, in many instances, have discretion in whether to keep a patient in the facility and expend additional care resources, or transfer the resident to the hospital," said Shubing Cai, Ph.D., lead author of the study and investigator at Brown University. "While we know that nursing homes tend to provide similar quality of care to all residents, hospitalization decisions are often different from the decisions involved in the provision of daily care and have a significant impact on the long-term health of residents."

Medicaid the joint federal and state health insurance program pays fo
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Contact: Mark Michaud
mark_michaud@urmc.rochester.edu
585-273-4790
University of Rochester Medical Center
Source:Eurekalert

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