FACTORS INFLUENCING THE USE OF MEDICARE'S SNFS BENEFIT

这项研究将分析由国家医疗保险研究收集的数据 三个城市地区医疗保险受益人的急性护理后使用情况： 明尼苏达州明尼阿波利斯/圣保罗；德克萨斯州休斯顿；匹兹堡， 宾夕法尼亚州。这项全国随机抽样研究的精选数据 5个DRG类别的2,687名联邦医疗保险受益人将被用于评估 患者和医院的特点对使用的影响 急诊SNF服务的后处理。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使用SNF的特殊模式。这个 这项研究还将考察养老院在决定最初的 联邦医疗保险有资格享受联邦医疗保险的SNF福利。一旦一个病人被 接受联邦医疗保险认证的SNF，不应该有与医疗无关的 与SNFS决定向Medicare开具账单的相关因素。然而，鉴于 拒绝医疗保险的追溯性质和覆盖范围、护理的不确定性 家庭可能更愿意为某些患者寻求医疗保险 也不太愿意为他人着想。这部分研究将基于 587名医保患者从医院转至熟练护理 设施。患者特定的数据文件将补充 从护理机构收集的关于初级和其他方面的信息 付款来源，账单是否已向联邦医疗保险提交，是否 付了钱，付了多久。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.