Strategic Patient Discharge: The Case of Long-Term Care Hospitals

Medientyp: E-Book

Titel: Strategic Patient Discharge : The Case of Long-Term Care Hospitals

Beteiligte: Eliason, Paul J. [Verfasser:in]; Roberts, James W. [Sonstige Person, Familie und Körperschaft]; Grieco, Paul L. E. [Sonstige Person, Familie und Körperschaft]; McDevitt, Ryan C. [Sonstige Person, Familie und Körperschaft]

Körperschaft: National Bureau of Economic Research

Erschienen: Cambridge, Mass: National Bureau of Economic Research, September 2016

Umfang: 1 Online-Ressource

Sprache: Englisch

DOI: 10.3386/w22598

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Reproduktionsnotiz: Hardcopy version available to institutional subscribers

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Beschreibung: Medicare's prospective payment system for long-term acute-care hospitals (LTCHs) pro- vides modest reimbursements at the beginning of a patient's stay before jumping discontinuously to a large lump-sum payment after a pre-specified number of days. We show that LTCHs respond to financial incentives by disproportionately discharging patients after they cross the large-payment threshold, resulting in worse outcomes for patients. We find this occurs more often at for-profit facilities, facilities acquired by leading LTCH chains, and facilities co-located with other hospitals. Using a dynamic structural model, we evaluate counterfactual payment policies that would provide substantial savings for Medicare without adversely affecting patients

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