FACTORS INFLUENCING THE USE OF MEDICARE'S SNFS BENEFIT

这项研究将分析国家医疗保险研究所收集的数据 医疗保险受益人在三个城市地区的急诊后护理使用情况： 明尼苏达州的明尼阿波利斯/圣保罗;得克萨斯州的休斯顿;和匹兹堡， 宾夕法尼亚这项全国性研究的随机样本中的选定数据 将使用五个DRG类别的2，687名医疗保险受益人来评估 患者和医院具体特征对使用的影响 急性期后SNF服务。这项研究的结果将提供 关于使用SNF服务的患者类型的描述性信息， 辨别医疗保险受益人之间SNF使用的特定模式。的 研究还将探讨疗养院在确定最初的 享受Medicare的SNF福利。一旦患者 承认一个医疗保险认证的SNF，不应该有非护理相关的 与SNF决定向Medicare收费相关的因素。然而，鉴于 医疗保险拒绝的追溯性和覆盖范围的不确定性，护理 家庭可能更愿意为某些病人寻求医疗保险 更不愿意为他人着想这部分研究将基于 587名医保患者从医院转入熟练护理 设施。患者特定数据文件将补充 从护理机构收集的关于主要和其他 支付来源，是否向医疗保险提交了账单，是否 支付和多久。分析将使用序贯logit回归。

This study will analyze data collected by the national study of Medicare post acute care use by Medicare beneficiaries in three urban areas: Minneapolis/St. Paul, Minnesota; Houston, Texas; and Pittsburgh, Pennsylvania. Selected data from this national study of a random sample of 2,687 Medicare beneficiaries in five DRG categories will be used to assess the influence of patient and hospital specific characteristics on the use of post acute SNF services. The results of this study will provide descriptive information on the types of patients using SNF services and discern particular patterns of SNF use among Medicare beneficiaries. The study will also look at the nursing homes' role in determining initial Medicare eligibility for Medicare's SNF benefit. Once a patient has been admitted to a Medicare certified SNF, there should be no non-care related factors associated with the SNFs decision to bill Medicare. Yet, given the retroactive nature of Medicare denials and uncertainty of coverage, nursing homes may be more willing to seek Medicare coverage for certain patients and less willing for others. This part of the study will be based on the 587 Medicare patients transferred from the hospital to a skilled nursing facility. The patient specific data file will be supplemented with information collected from the nursing facilities as to primary and other payment sources, whether a bill was filed with Medicare, whether it was paid and for how long. The analysis will use a sequential logit regression.