title: The impact of DRGs on community-based service providers: implications for the elderly.
abstract: We investigated changes in community-based agencies following the implementation of the Medicare prospective payment system for hospitals utilizing DRGs (diagnosis-related groups). Data were collected in 1986 and 1987 from 771 community service providers. There were five major findings: 1) hospital discharge planners, nursing homes, and home health agencies experienced DRG effects before other types of community providers studies; 2) the "reach" of DRG impact is widespread; 3) providers report a change in clientele toward a heavier-care client; 4) the impact of DRGs affects the types of services agencies provide; and 5) community providers have experienced a decrease in their ability to refer their clients both to hospitals and to each other.
authors.affiliation: Institute for Health & Aging, University of California-San Francisco 94143-0646.
authors.forename: J B
authors.initials: JB
authors.lastname: Wood
authors.forename: C L
authors.initials: CL
authors.lastname: Estes
mesh_terms: D000359:Aftercare / Q000458:organization & administration; D000368:Aged; D003153:Community Health Services / Q000191:economics / Q000458:organization & administration*; D003625:Data Collection; D003953:Diagnosis-Related Groups; D005069:Evaluation Studies as Topic; D006760:Hospitalization; D006801:Humans; D006278:Medicare; D009936:Organizational Innovation; D010351:Patient Discharge; D011445:Prospective Payment System; D012017:Referral and Consultation; D014481:United States