Do Medicaid Wage Pass-through Payments Increase Nursing Home Staffing?
Do Medicaid Wage Pass-through Payments Increase Nursing Home Staffing?
复制标题
DOI：
10.1111/j.1475-6773.2010.01109.x
复制
发表时间：
2010-06-01
影响因子：
3.4
通讯作者：
Mor, Vincent
中科院分区：
文献类型：
--
作者：
Feng, Zhanlian;Lee, Yong Suk;Mor, Vincent
目的评估国家医疗补助工资传递政策对美国养老院直接护理人员水平的影响。数据来源：在线调查认证和报告（OSCAR）数据，以及1996-2004年期间的国家医疗补助养老院报销政策。研究设计采用两步可行广义最小二乘估计的固定效应面板模型来检验传递收养对养老院直接护理人员每住院日工作时间（HPRD）的影响。数据收集/提取方法跟踪研究期间每家机构年度OSCAR调查的面板数据文件与州医疗补助工资传递和相关政策的年度信息相关联。在研究期间引入工资传递的州中，该政策与认证护士助理（CNA） HPRD在采用后的几年中净增长3.0%至4.0%有关。注册护士和执业护士HPRD均未观察到明显的传递效应。结论：至少在短期内，国家医疗补助工资传递计划提供了一个潜在有效的政策工具，可以促进养老院直接护理CNA人员的配备。
ObjectiveTo assess the impact of state Medicaid wage pass-through policy on direct-care staffing levels in U.S. nursing homes.Data SourcesOnline Survey Certification and Reporting (OSCAR) data, and state Medicaid nursing home reimbursement policies over the period 1996-2004.Study DesignA fixed-effects panel model with two-step feasible-generalized least squares estimates is used to examine the effect of pass-through adoption on direct-care staff hours per resident day (HPRD) in nursing homes.Data Collection/Extraction MethodsA panel data file tracking annual OSCAR surveys per facility over the study period is linked with annual information on state Medicaid wage pass-through and related policies.Principal FindingsAmong the states introducing wage pass-through over the study period, the policy is associated with between 3.0 and 4.0 percent net increases in certified nurse aide (CNA) HPRD in the years following adoption. No discernable pass-through effect is observed on either registered nurse or licensed practical nurse HPRD.ConclusionsState Medicaid wage pass-through programs offer a potentially effective policy tool to boost direct-care CNA staffing in nursing homes, at least in the short term.