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首页> 外文期刊>Journal of health economics >Medicare prospective payment and the volume and intensity of skilled nursing facility services^
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Medicare prospective payment and the volume and intensity of skilled nursing facility services^

机译：Medicare预期付款以及熟练护理设施服务的数量和强度^

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摘要

In 1998, Medicare adopted a per diem Prospective Payment System (PPS) for skilled nursing facility care, which was intended to deter the use of high-cost rehabilitative services. The average per diem decreased under the PPS, but because per diems increased for greater therapy minutes, the ability of the PPS to deter the use of high-intensity services was questionable. In this study, we assess how the PPS affected the volume and intensity of Medicare services. By volume we mean the product of the number of Medicare residents in a facility and the average length-of-stay, by intensity we mean the time per week devoted to rehabilitation therapy. Our results indicate that the number of Medicare residents decreased under PPS, but rehabilitative services and therapy minutes increased while length-of-stay remained relatively constant. Not surprisingly, when subsequent Medicare policy changes increased payment rates. Medicare volume far surpassed the levels seen in the pre-PPS period.
机译：1998年，Medicare为熟练护理设施护理采用了每日津贴预付款系统（PPS），旨在阻止使用高成本的康复服务。在PPS下平均每日减少，但由于在更长的治疗时间里每日增加，因此PPS阻止使用高强度服务的能力值得怀疑。在这项研究中，我们评估了PPS如何影响Medicare服务的数量和强度。按数量，我们指的是设施中医疗保险居民人数与平均住院时间的乘积，按强度，我们指的是每周用于康复治疗的时间。我们的结果表明，按照PPS进行医疗保险的居民人数有所减少，但康复服务和治疗时间增加了，而住院时间却保持相对恒定。毫不奇怪，当随后的医疗保险政策更改增加支付率时。 Medicare的数量远远超过了PPS之前的水平。

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