title: Implications of global budget payment system on nursing home costs.
abstract: Pressure on health care systems due to the increasing expenditures of the elderly population is pushing policy makers to adopt new regulation and payment schemes for nursing home services. We consider the behavior of nonprofit nursing homes under different payment schemes and empirically investigate the implications of prospective payments on nursing home costs under tightly regulated quality aspects. To evaluate the impact of the policy change introduced in 2006 in Southern Switzerland - from retrospective to prospective payment - we use a panel of 41 homes observed over a 10-years period (2001-2010). We employ a fixed effects model with a time trend that is allowed to change after the policy reform. There is evidence that the new payment system slightly reduces costs without impacting quality.
authors.affiliation: Institute of Economics (IdEP), University of Lugano, , Switzerland.
authors.forename: Laura
authors.initials: L
authors.lastname: Di Giorgio
authors.affiliation: Institute of Economics (IdEP), University of Lugano, , Switzerland; ETH Zurich, Switzerland.
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippini
authors.affiliation: Institute of Economics (IdEP), University of Lugano, , Switzerland; Department of Engineering, University of Bergamo, Italy. Electronic address: giuliano.masiero@usi.ch.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Masiero
mesh_terms: D003363:Cost Control / Q000191:economics / Q000458:organization & administration; D017048:Health Care Costs / Q000706:statistics & numerical data; D006291:Health Policy; D006801:Humans; D009735:Nursing Homes / Q000191:economics* / Q000458:organization & administration / Q000592:standards; D011445:Prospective Payment System / Q000191:economics*; D011787:Quality of Health Care / Q000191:economics / Q000458:organization & administration; D013557:Switzerland
keywords: Nursing homes; Policy change; Prospective payment; Quality of care