A clinically based service limitation option for alternative model rural hospitals.
Alternative model rural hospitals are designed to address problems faced by small, isolated rural hospitals. Typically, hospital regulations are reduced in exchange for a limit on the services that alternative models may offer. The most common service limitation is a limit on length of stay (LOS), a method with little empirical or conceptual support. The purpose of this article is to present a clinically based service limitation for alternative model rural hospitals, such as the rural primary care hospital. The proposal is based on an analysis of Medicare discharges from rural hospitals most likely to convert and the judgments of a technical advisory panel of rural clinicians.
Moscovice
I
I
Institute for Health Services Research, University of Minnesota, Minneapolis 55455.
Wellever
A
A
Sales
A
A
Chen
M M
MM
Christianson
J
J
D000368:Aged; D003625:Data Collection; D003953:Diagnosis-Related Groups / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006302:Health Services Research; D006752:Hospital Planning / Q000331:legislation & jurisprudence*; D006780:Hospitals, Rural / Q000191:economics / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000331:legislation & jurisprudence; D016344:Medicare Part A / Q000331:legislation & jurisprudence*; D017146:Models, Organizational; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011366:Professional Review Organizations; D014481:United States; D014600:Utilization Review