Prospective payment for rehabilitation: effects on hospital readmission, home care, and placement
Suspected benefits of a prospective payment system (PPS) in which hospitals are paid by diagnosis-related groups (DRGs) are that hospital lengths of stay and costs may be reduced. The US Department of Veterans Affairs is one of the first agencies to adopt PPS funding for rehabilitation; this early a...
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| Veröffentlicht in: | Archives of physical medicine and rehabilitation 1990-04, Vol.71 (5), p.291-294 |
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| container_title | Archives of physical medicine and rehabilitation |
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| creator | EVANS, R. L HENDRICKS, R. D BISHOP, D. S LAWRENCE-UMLAUF, K. V KIRK, C HALAR, E. M |
| description | Suspected benefits of a prospective payment system (PPS) in which hospitals are paid by diagnosis-related groups (DRGs) are that hospital lengths of stay and costs may be reduced. The US Department of Veterans Affairs is one of the first agencies to adopt PPS funding for rehabilitation; this early adoption of PPS provides a unique opportunity to test for both beneficial and adverse outcomes. This study compared hospital stay, readmission rate, and incidence of nursing home placement before and after introduction of PPS on a 22-bed rehabilitation service. Hospital stay decreased from 29.3 days to 26.4 days, but 64% more patients were discharged to nursing homes. Findings suggest that PPS may overlook home care in favor of placement, which neutralizes the cost benefits of the proposed reimbursement system. Further research on the effects of PPS is needed to determine (1) impact on clinical aspects of rehabilitation and (2) whether other funding mechanisms are more appropriate. |
| format | Article |
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Findings suggest that PPS may overlook home care in favor of placement, which neutralizes the cost benefits of the proposed reimbursement system. Further research on the effects of PPS is needed to determine (1) impact on clinical aspects of rehabilitation and (2) whether other funding mechanisms are more appropriate.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>PMID: 2109588</identifier><identifier>CODEN: APMHAI</identifier><language>eng</language><publisher>New York, NY: Elsevier</publisher><subject>Biological and medical sciences ; Diagnosis-Related Groups ; Female ; Home Care Services ; Hospitals, Veterans ; Humans ; Length of Stay ; Male ; Massachusetts ; Medical sciences ; Middle Aged ; Nursing Homes ; Outcome and Process Assessment (Health Care) ; Patient Discharge ; Patient Readmission - economics ; Prospective Payment System - economics ; Public health. Hygiene ; Public health. 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V</creatorcontrib><creatorcontrib>KIRK, C</creatorcontrib><creatorcontrib>HALAR, E. M</creatorcontrib><title>Prospective payment for rehabilitation: effects on hospital readmission, home care, and placement</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Suspected benefits of a prospective payment system (PPS) in which hospitals are paid by diagnosis-related groups (DRGs) are that hospital lengths of stay and costs may be reduced. The US Department of Veterans Affairs is one of the first agencies to adopt PPS funding for rehabilitation; this early adoption of PPS provides a unique opportunity to test for both beneficial and adverse outcomes. This study compared hospital stay, readmission rate, and incidence of nursing home placement before and after introduction of PPS on a 22-bed rehabilitation service. Hospital stay decreased from 29.3 days to 26.4 days, but 64% more patients were discharged to nursing homes. Findings suggest that PPS may overlook home care in favor of placement, which neutralizes the cost benefits of the proposed reimbursement system. Further research on the effects of PPS is needed to determine (1) impact on clinical aspects of rehabilitation and (2) whether other funding mechanisms are more appropriate.</description><subject>Biological and medical sciences</subject><subject>Diagnosis-Related Groups</subject><subject>Female</subject><subject>Home Care Services</subject><subject>Hospitals, Veterans</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Massachusetts</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nursing Homes</subject><subject>Outcome and Process Assessment (Health Care)</subject><subject>Patient Discharge</subject><subject>Patient Readmission - economics</subject><subject>Prospective Payment System - economics</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Rehabilitation - economics</subject><subject>Retrospective Studies</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1990</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1LxDAQhoMo67r6E4QcxNMW8tG0iTdZ_IIFPSh4K9Nkwlb6ZdIV9t8bsXj1NMz7PvMyM0dkyZUUmRb8_ZgsGWMyM8bIU3IW40dqCyX5giwEZ0ZpvSTwEoY4op2aL6QjHDrsJ-qHQAPuoG7aZoKpGfobit4nKtKhp7s0kfQ2MeC6JsYErJPaIbUQcE2hd3RsweJP2jk58dBGvJjrirzd371uHrPt88PT5nabjaIopkxIlhuZa2TccjTWq3SIKmyual5aa73jykvAXEjumMYaVV07bspCWIfOyBW5_s0dw_C5xzhVaTWLbQs9DvtYlaaUIlf6X5DrUrBSywRezuC-7tBVY2g6CIdqfl7yr2YfooXWB-htE_-wvBBcaCO_AWTJefE</recordid><startdate>19900401</startdate><enddate>19900401</enddate><creator>EVANS, R. L</creator><creator>HENDRICKS, R. D</creator><creator>BISHOP, D. S</creator><creator>LAWRENCE-UMLAUF, K. V</creator><creator>KIRK, C</creator><creator>HALAR, E. 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Hygiene-occupational medicine</topic><topic>Rehabilitation - economics</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>EVANS, R. L</creatorcontrib><creatorcontrib>HENDRICKS, R. D</creatorcontrib><creatorcontrib>BISHOP, D. S</creatorcontrib><creatorcontrib>LAWRENCE-UMLAUF, K. V</creatorcontrib><creatorcontrib>KIRK, C</creatorcontrib><creatorcontrib>HALAR, E. M</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Physical Education Index</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>EVANS, R. L</au><au>HENDRICKS, R. D</au><au>BISHOP, D. S</au><au>LAWRENCE-UMLAUF, K. V</au><au>KIRK, C</au><au>HALAR, E. M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective payment for rehabilitation: effects on hospital readmission, home care, and placement</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>1990-04-01</date><risdate>1990</risdate><volume>71</volume><issue>5</issue><spage>291</spage><epage>294</epage><pages>291-294</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><coden>APMHAI</coden><abstract>Suspected benefits of a prospective payment system (PPS) in which hospitals are paid by diagnosis-related groups (DRGs) are that hospital lengths of stay and costs may be reduced. The US Department of Veterans Affairs is one of the first agencies to adopt PPS funding for rehabilitation; this early adoption of PPS provides a unique opportunity to test for both beneficial and adverse outcomes. This study compared hospital stay, readmission rate, and incidence of nursing home placement before and after introduction of PPS on a 22-bed rehabilitation service. Hospital stay decreased from 29.3 days to 26.4 days, but 64% more patients were discharged to nursing homes. Findings suggest that PPS may overlook home care in favor of placement, which neutralizes the cost benefits of the proposed reimbursement system. Further research on the effects of PPS is needed to determine (1) impact on clinical aspects of rehabilitation and (2) whether other funding mechanisms are more appropriate.</abstract><cop>New York, NY</cop><pub>Elsevier</pub><pmid>2109588</pmid><tpages>4</tpages></addata></record> |
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| ispartof | Archives of physical medicine and rehabilitation, 1990-04, Vol.71 (5), p.291-294 |
| issn | 0003-9993 1532-821X |
| language | eng |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals |
| subjects | Biological and medical sciences Diagnosis-Related Groups Female Home Care Services Hospitals, Veterans Humans Length of Stay Male Massachusetts Medical sciences Middle Aged Nursing Homes Outcome and Process Assessment (Health Care) Patient Discharge Patient Readmission - economics Prospective Payment System - economics Public health. Hygiene Public health. Hygiene-occupational medicine Rehabilitation - economics Retrospective Studies |
| title | Prospective payment for rehabilitation: effects on hospital readmission, home care, and placement |
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