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Seniors moving to HCBS face more hospital risk
Date:1/8/2014

pays for medical care, meaning that Medicaid programs do not have a built-in financial incentive to prevent hospitalizations. Home- and community-based care is less expensive for Medicaid regardless of the medical outcome.

Careful comparison

Wysocki performed the analysis for her doctoral thesis work at the University of Minnesota. She and her co-authors looked at a set of records provided by the Centers for Medicare and Medicaid Services of thousands of dually eligible seniors from Arkansas, Florida, Minnesota, New Mexico, Texas, Vermont, and Washington who entered nursing homes between 2003 and 2005.

Based on those records, Wysocki and her team determined who made the transition to community and home care and who stayed in the nursing home. Accounting for a wide variety of demographic and medical factors, they then compared the rate of hospitalizations among 1,169 seniors who transitioned to the community ("transitioners") and 1,169 otherwise similar seniors who stayed in the nursing home ("stayers").

What Wysocki observed was that 133 transitioners ended up hospitalized for potentially preventable reasons, while only 113 stayers did. Including "non-preventable" hospitalizations, the numbers rose to 419 among transitioners and 297 among stayers.

Those raw numbers don't quite tell the whole story in comparing overall hospitalization risk, however, because seniors in the stayers group also generally took a longer time to reach that first hospitalization than seniors in the transitioners group. Using a standard statistical technique to account for the time difference, Wysocki found that transitioners faced a 40-percent greater risk of enduring a potentially preventable hospitalization and a 58-percent greater risk of any kind of hospitalization than the stayers did.

Making care less fragmented

The study, published Jan. 2, 2014, concludes with a clear recommendation: "Ensuring that an individ
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Contact: David Orenstein
david_orenstein@brown.edu
401-863-1862
Brown University
Source:Eurekalert

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