Closures and mergers of VNA home care agencies: a model for the study of causal factors.
Recent closures and mergers of visiting nurses associations (VNAs) raise some potentially serious questions regarding access to home care for the elderly Medicare and Medicaid populations. While VNAs comprise less than 10 percent of the nation's certified home health agencies, they provide approximately 31 percent of all medicare home care (HCFA, 1989). In March of 1986 there were 524 visiting nurses associations nationally whereas today there remain only 495 (HCFA, 1990). A model identifying potential causes of VNA mortality is presented along with some preliminary results. VNA mortality is defined and measured by the date that Medicare certification is terminated as a result of VNA closure or merger.
Scalzi
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CC
School of Nursing, University of Pennsylvania, Philadelphia 19104.
Meyer
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D000368:Aged; D014487:Centers for Medicare and Medicaid Services, U.S.; D002568:Certification / Q000331:legislation & jurisprudence; D003152:Community Health Nursing / Q000191:economics* / Q000706:statistics & numerical data; D006271:Health Facility Closure / Q000706:statistics & numerical data*; D006273:Health Facility Merger / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods; D006699:Home Care Services / Q000191:economics* / Q000600:supply & distribution; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence; D007355:Insurance, Nursing Services / Q000331:legislation & jurisprudence; D006278:Medicare / Q000191:economics / Q000331:legislation & jurisprudence*; D015233:Models, Statistical; D014481:United States