HOSPITALIZATIONS OF NURSING HOME RESIDENTS

疗养院居民使用急性住院服务是一个 医疗保险支出的庞大和不明确的来源。 更好的 医院利用率的大小和预测因素的定义 应当为制定和评估节省费用措施提供依据 替代战略。 为此，今年的目标是 研究建议是计算利率，成本和预测因素， 住院的老年护理院居民在一个明确的 纽约门罗县社区。 预先收集，大部分计算机化 由门罗县长期管理局维护的使用审查数据 护理计划（访问）的所有养老院居民在县将 用于分析。 这些数据包括广泛的措施， 功能和医疗状况的养老院居民，以及选择 护理院的描述符，所有这些都将被考虑在推导 预测方程 本研究将分析 居住在专业护理机构（SNF）和 1982日历年中级护理设施的情况， SNF和ICF分别约有850人和300人住院治疗 分别 特别注意将集中在大约200个 多次入院的人，他们可能是最高的 患者的成本。 因为这项研究是基于功能和医学参数， 在长期护理患者中广泛用于利用审查 预计该项目的结果将 可推广到其他设置。 根据在执行该项目过程中制定的方法， 研究的第一阶段将侧重于使用急症医院， 在自己家中获得社区长期护理的患者 或在庇护所。 将制定并提交给 下一年继续提供资金。

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.