Trends in Medicare disproportionate share (DSH) distribution in US hospitals: 1996-2003.
Implemented in 1986, Medicare's disproportionate share (DSH) adjustment is intended to recognize hospitals' additional resource investment in caring for low-income patients. This project analyzed changes in the DSH percentage between 1996 and 2003 and examined the association between selected hospital characteristics and such changes. Results obtained revealed some interesting findings. First, minimal changes in DSH percentage occurred during the period 1996-1999 with a hike in that ratio in 2000-2001. However, even with the absence of any legislative or executive changes to the DSH threshold or formula during 2002 and 2003, significant increases occurred during 2001-2003 (11 percent increase between 2001 and 2003). Such an increase may be caused by the nation's economic situation during that timeframe (i.e., more people depending on public programs for coverage).
Saleh
Shadi S
SS
Department of Health Policy, Management and Behavior, School of Public Health, State University of New York at Albany, USA.
Callan
Mark
M
D000368:Aged; D002391:Catchment Area, Health / Q000191:economics / Q000706:statistics & numerical data; D004608:Eligibility Determination; D005377:Financial Management, Hospital / Q000706:statistics & numerical data / Q000639:trends*; D006297:Health Services Accessibility / Q000191:economics; D016304:Hospitals, Private / Q000191:economics / Q000706:statistics & numerical data; D006777:Hospitals, Proprietary / Q000191:economics / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data / Q000639:trends*; D016344:Medicare Part A / Q000706:statistics & numerical data / Q000639:trends*; D015999:Multivariate Analysis; D016311:Outliers, DRG / Q000191:economics* / Q000706:statistics & numerical data*; D011203:Poverty / Q000706:statistics & numerical data; D011445:Prospective Payment System / Q000639:trends*; D013659:Tax Equity and Fiscal Responsibility Act; D017664:Uncompensated Care / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States