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Patients Are Not Given Quality-Of-Care Data About Skilled Nursing Facilities When Discharged From Hospitals
RTI Int, Aging Disabil & Long Term Care Program, Waltham, MA 02452 USA.;Brown Univ, Sch Publ Hlth, Ctr Gerontol & Healthcare Res, Providence, RI 02912 USA..
Brown Univ, Sch Publ Hlth, Ctr Gerontol & Healthcare Res, Providence, RI 02912 USA..
Columbia Univ, Mailman Sch Publ Hlth, Dept Hlth Policy & Management, New York, NY USA..
Brown Univ, Sch Publ Hlth, Ctr Gerontol & Healthcare Res, Providence, RI 02912 USA..
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2017 (English)In: Health Affairs, ISSN 0278-2715, E-ISSN 1544-5208, Vol. 36, no 8, 1385-1391 p.Article in journal (Refereed) Published
Abstract [en]

Hospitals are now being held at least partly accountable for Medicare patients' care after discharge, as a result of regulations and incentives imposed by the Affordable Care Act. However, little is known about how patients select a postacute care facility. We used a multiple case study approach to explore both how patients requiring postacute care decide which skilled nursing facility to select and the role of hospital staff members in this decision. We interviewed 138 staff members of sixteen hospitals and twenty-five skilled nursing facilities and 98 patients in fourteen of the skilled nursing facilities. Most patients described receiving only lists of skilled nursing facilities from hospital staff members, while staff members reported not sharing data about facilities' quality with patients because they believed that patient choice regulations precluded them from doing so. Consequently, patients' choices were rarely based on readily available quality data. Proposed changes to the Medicare conditions of participation for hospitals that pertain to discharge planning could rectify this problem. In addition, less strict interpretations of choice requirements would give hospitals flexibility in the discharge planning process and allow them to refer patients to higher-quality facilities.

Place, publisher, year, edition, pages
2017. Vol. 36, no 8, 1385-1391 p.
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:uu:diva-332672DOI: 10.1377/hlthaff.2017.0155ISI: 000407080200006PubMedID: 28784730OAI: oai:DiVA.org:uu-332672DiVA: diva2:1153765
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2017-10-31Bibliographically approved

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