The effects of Medicaid reimbursement method and ownership on nursing home costs, case mix, and staffing.
The effects of Medicaid reimbursement method and ownership on nursing home costs, case mix, and staffing.
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医疗补助报销方法和所有权对疗养院成本、病例组合和人员配置的影响。
DOI：
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发表时间：
1990
期刊：
影响因子：
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通讯作者：
D. Lc
中科院分区：
文献类型：
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作者：
C. Jw;D. Lc
在这项研究中，我们分析了所有权和医疗补助成本控制措施对养老院成本，付款人组合，案例组合和人员配置的影响，使用1981年的医疗保险成本报告和医疗保险/医疗补助自动认证文件。随着医疗补助成本控制激励机制的加强，养老院的应对措施是减少病例组合和大幅减少人员配备。当这些激励措施特别强烈时，工作人员的减少就超过了根据案件组合显然适当的水平。此外，虽然连锁设施的成本低于其他类型的设施，但这些较低的成本似乎并不来自增加撇奶油或减少工作人员。
In this study we analyze the effects of ownership and Medicaid cost containment initiatives on nursing home costs, payer mix, case mix, and staffing, using 1981 Medicare cost reports and Medicare/Medicaid Automated Certification files. As Medicaid cost containment incentives become stronger, nursing homes respond by decreasing case mix and commensurately decreasing staffing. When these incentives are especially strong, staffing is reduced beyond the apparently appropriate level, given the case mix. In addition, while chain facilities have lower costs than other types of facilities, these lower costs do not appear to come from either increased cream-skimming or reduced staffing levels.