HOSPITALIZATIONS OF NURSING HOME RESIDENTS

疗养院居民使用急症医院住院服务是一种 医疗保险支出来源规模庞大且不明确。 更好的 医院利用程度的定义和预测因素 应为开发和评估成本节约提供基础 替代策略。 为此，今年的目标 研究计划是计算比率、成本和预测因素 老年疗养院居民的住院治疗有明确的规定 纽约州门罗县社区。 预先收集，大部分计算机化 由门罗县长期维护的利用审查数据 针对该县所有疗养院居民的护理计划 (ACCESS) 将 用于分析。 这些数据包括一系列广泛的衡量指标 疗养院居民的功能和医疗状况以及选定的 疗养院的描述符，所有这些都将在推导时考虑 预测方程。 该研究将分析人们的经验 居住在熟练护理机构 (SNF) 和 1982 日历年的中间护理设施（ICF），在此期间 大约有 850 人和 300 人因 SNF 和 ICF 住院 分别。 将特别关注约 200 个 多次住院的人可能是最高的 花费患者。 因为该研究是基于功能和医学参数 广泛用于长期护理患者的使用审查 预计该项目的调查结果将 可推广到其他设置。 根据该项目执行过程中开发的方法，第二个 研究阶段的设计重点是急症医院的使用 访问居住在社区的长期护理患者自己的家中 或在庇护所内。 这将被开发并提交给 下一年的持续资助。

Use of acute hospital inpatient services by nursing home residents is a sizeable and poorly defined source of Medicare expenditure. A better defintiion of the magnitude and predictors of this utilization of hospitals should provide a basis for developing and evaluating cost-saving alternative strategies. Toward this end, the objectives of this one year research proposal are to compute rates, costs and predictors of hospitalization of elderly nursing home residents in a well-defined community, Monroe County, New York. Pre-collected, largely computerized utilization review data which are maintained by the Monroe County Long-Term Care Program (ACCESS) on all nursing home residents in the county will be utilized for the analyses. The data include a wide range of measures of functional and medical status of nursing home residents as well as selected descriptors of nursing homes, all of which will be considered in deriving predictor equations. The study will analyze the experiences of the populations residing in both skilled nursing facilities (SNF) snd intermediate care facilities (ICF) for the calendar year 1982 during which there were approximately 850 and 300 hospitalizations from SNFs and ICFs respectively. Special attention will be focused upon some two hundred persons with multiple hospital admissions who are likely to be the highest cost patients. Because the study is based upon functional and medical parameters which are in widespread use for utilization review in long-term care patient populations it is anticipated that findings from this project will be generalizable to other settings. Based upon methodology developed in execution of this project, a second phase of study will be designed to focus on use of acute hospitals by ACCESS long-term care patients living in the community in their own homes or in sheltered housing. This will be developed and submitted for continuation funding for the following year.