Use of postacute care by nursing home residents hospitalized for stroke or hip fracture: how prevalent and to what end?
OBJECTIVE
To examine nursing home (NH) residents' use of Medicare-paid skilled nursing facility (SNF) services and the outcomes of that care and to identify clinical and non-clinical factors associated with that care.


METHODS
Retrospective cohort.


METHODS
United States.


METHODS
NH residents aged 65 and older with Medicare claims for a hospitalization for hip fracture or stroke during 2001 to 2003.


METHODS
Resident diagnoses and use of SNF postacute care were measured using Medicare hospital claims. Market and provider characteristics were drawn from the Provider of Services file. Baseline characteristics, institutionalization, and mortality outcomes were drawn from the Minimum Data Set and Medicare Denominator File.


RESULTS
Of the NH population hospitalized for hip fracture (49,903) or stroke (23,084), 79.7% and 64.1%, respectively, used the SNF benefit. Residents not using the SNF benefit had poorer baseline health status; their mortality rates and rates of resuming long-term care were similar to the rates of residents who used the SNF benefit.


CONCLUSIONS
NH residents used postacute SNF benefits at high rates yet had similar mortality and institutionalization outcomes as those without SNF care.
Hoverman
Carrie
C
Department of Health Services and Policy Analysis, University of California at Berkeley, Berkeley, California, USA. carrieh@berkeley.edu
Shugarman
Lisa R
LR
Saliba
Debra
D
Buntin
Melinda Beeuwkes
MB
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006620:Hip Fractures / Q000191:economics / Q000401:mortality / Q000534:rehabilitation*; D006707:Homes for the Aged / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007342:Insurance Benefits / Q000191:economics; D008297:Male; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data*; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000191:economics; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities / Q000191:economics / Q000706:statistics & numerical data*; D020521:Stroke / Q000191:economics / Q000401:mortality; D000071939:Stroke Rehabilitation; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data