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Study compares types of insurance of nursing home residents and likelihood of being hospitalized
Date:9/26/2013

re, especially at the end of life. Ultimately, it may require a change in the underlying financial structure to institute those changes," the study concludes.

(JAMA Intern Med. Published online September 23, 2013. doi:10.1001/jamainternmed.2013.10573. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: This study was supported in part by grants from the National Institute on Aging. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: The Right Care in the Right Place

In an invited commentary, William J. Hall, M.D., M.A.C.P., writes: "Two key factors stand out from this study. First, more onsite nurse practitioners in nursing homes resulted in better outcomes irrespective of insurance status. Second, present Medicaid reimbursement creates perverse incentives against the delivery of appropriate comfort and palliative care such as hospital services."

"Design of a long-term system that will provide our patients with advanced dementia the right care at the right time will require more than patches and fixes to the payments systems," Hall continues.

"Finally, no individual is admitted to a hospital or nursing home without the authorization of a physician. We, more than any other members of the health care team, have the authority and responsibility to advocate for the appropriate level of care for our patients during the terminal phase of advanced dementia," Hall concludes.

(JAMA Intern Med. Published online September 23, 2013. doi:10.1001/jamainternmed.2013.8592. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: Please see the article for additional information, including other authors, author
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Contact: Lorinda Klein
lorindaann.klein@nyumc.org
212-404-3533
The JAMA Network Journals
Source:Eurekalert

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