The effect of cuts in medicare reimbursement on hospital mortality
The effect of cuts in medicare reimbursement on hospital mortality
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DOI：
10.1111/j.1475-6773.2006.00507.x
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发表时间：
2006-06-01
影响因子：
3.4
通讯作者：
Volpp, Kevin G.
中科院分区：
文献类型：
--
作者：
Seshamani, Meena;Schwartz, J. Sanford;Volpp, Kevin G.
objective.确定1997年平衡预算法案（BBA）规定的不同财务压力水平下在医院接受治疗的患者30天死亡率是否有差异变化，以及弱势患者人群（如未投保人群）是否受到不成比例的影响。1997年至2001年宾夕法尼亚州所有普通急症护理医院的出院数据。使用宾夕法尼亚州的出院数据、医院财务数据和死亡证明信息，对30天死亡率进行了回顾性多元回归分析。数据收集。我们使用了370，017次住院事件，其中四种情况由医疗保健研究和质量机构确定为住院质量指标。据估计，1998年，BBA影响低的医院和影响高的医院的医疗保险付款减少对总净收入的平均幅度分别为1.8%和3.6%，到2001年分别恶化到2%和4.8%。在此期间，所有医院的营业利润率均显著下降（p
Objective. To determine if patients treated at hospitals under different levels of financial strain from the Balanced Budget Act (BBA) of 1997 had differential changes in 30-day mortality, and whether vulnerable patient populations such as the uninsured were disproportionately affected.Data Source. Hospital discharge data from all general acute care hospitals in Pennsylvania from 1997 to 2001.Study Design. A multivariate regression analysis was performed retrospectively on 30-day mortality rates, using hospital discharge data, hospital financial data, and death certificate information from Pennsylvania.Data Collection. We used 370,017 hospital episodes with one of four conditions identified by the Agency for Healthcare Research and Quality as inpatient quality indicators were extracted.Principal Findings. The average magnitude of Medicare payment reduction on overall net revenues was estimated at 1.8 percent for hospitals with low BBA impact and 3.6 percent for hospitals with a high impact in 1998, worsening to 2 and 4.8 percent, respectively, by 2001. Operating margins decreased significantly over the time period for all hospitals (p