title: The downstream financial effects of a nursing home practice on an academic medical center.
abstract: OBJECTIVE
  To determine the financial impact of a nursing home practice on an academic medical center.
  
  
  METHODS
  Retrospective cohort design.
  
  
  METHODS
  Middle-sized Midwestern community with fee-for-service Medicare population.
  
  
  METHODS
  One hundred seventy-six nursing home residents followed by faculty and residents of a medical school department of family and community medicine.
  
  
  METHODS
  Billings and collections for professional and hospital services delivered by the academic medical center during fiscal year 1998.
  
  
  RESULTS
  One hundred forty-four patient-years of service resulted in over 1 million dollars in billed charges. For every 1 dollar billed by family medicine, consulting physicians billed 2 dollars and the hospital billed 10 dollars. This amounted to over 4000 dollars per patient per year in reimbursement. This practice generated a wide variety of clinical problems (37 different diagnosis-related groups (DRGs) for the 61 admissions to the hospital).
  
  
  CONCLUSIONS
  There is a significant downstream financial effect of a nursing home practice on an academic health center. For this and other reasons, this practice may be worthy of institutional support.
authors.affiliation: Department of Family and Community Medicine, University of Missouri School of Medicine, Columbia 65212, USA.
authors.forename: S
authors.initials: S
authors.lastname: Zweig
authors.forename: L W
authors.initials: LW
authors.lastname: Lawhorne