Journal article
Trends in observation care among Medicare fee-for-service beneficiaries at critical access hospitals, 2007-2009
The Journal of rural health, Vol.29 Suppl 1(s1), pp.s1-s6
08/2013
DOI: 10.1111/jrh.12007
PMCID: PMC3752707
PMID: 23944275
Abstract
Observation care is used to evaluate patients prior to admission or discharge. Often beneficial, such care also imposes greater financial liability on Medicare beneficiaries. While the use of observation care has increased recently, critical access hospitals (CAHs) face different policies than prospective payment (PPS) hospitals, which may influence their observation care use.
We used 100% Medicare inpatient and outpatient claims files and enrollment data for years 2007 to 2009, and the 2007 American Hospital Association data to compare trends in the likelihood, prevalence and duration of observation stays between CAHs and PPS hospitals in metro and non-metro areas among fee-for-service Medicare beneficiaries over age 65.
While PPS hospitals are more likely to provide any observation care, the 3-year increase in the proportion of CAHs providing any observation care is approximately 5 times as great as the increase among PPS hospitals. Among hospitals providing any observation care in 2007, the prevalence at CAHs was 35.7% higher than at non-metro PPS hospitals and 72.8% higher than at metro PPS hospitals. By 2009, these respective figures had increased to 63.1% and 111%. Average stay duration increased more slowly for CAHs than for PPS hospitals.
These data suggest that a growing proportion of CAHs are providing observation care and that CAHs provide relatively more observation care than PPS hospitals, but they have shorter average stays. This may have important financial implications for Medicare beneficiaries.
Details
- Title: Subtitle
- Trends in observation care among Medicare fee-for-service beneficiaries at critical access hospitals, 2007-2009
- Creators
- Brad Wright - Brown UniversityHye-Young Jung - Brown UniversityZhanlian Feng - Brown UniversityVincent Mor - Brown University
- Resource Type
- Journal article
- Publication Details
- The Journal of rural health, Vol.29 Suppl 1(s1), pp.s1-s6
- DOI
- 10.1111/jrh.12007
- PMID
- 23944275
- PMCID
- PMC3752707
- NLM abbreviation
- J Rural Health
- ISSN
- 0890-765X
- eISSN
- 1748-0361
- Grant note
- P01 AG027296 / NIA NIH HHS T32 HS000011 / AHRQ HHS P01AG027296 / NIA NIH HHS 5T32H000011-27 / PHS HHS
- Language
- English
- Date published
- 08/2013
- Academic Unit
- Public Policy Center (Archive)
- Record Identifier
- 9984364534402771
Metrics
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