• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Health services research: HSR >Utilization of home health services before and after the Balanced Budget Act of 1997: what were the initial effects?
【24h】

Utilization of home health services before and after the Balanced Budget Act of 1997: what were the initial effects?

机译：1997年《平衡预算法案》前后的家庭保健服务利用：最初的影响是什么？

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: To estimate the impact of the Balanced Budget Act of 1997 (BBA), which changed the way Medicare reimbursed for home health services, on a range of home health utilization measures, and to examine whether particular subgroups of beneficiaries were differentially impacted in the post-BBA period. DATA SOURCES: Secondary data from the Centers for Medicare and Medicaid Services (CMS) Standard Analytic Files for the 1 percent sample of Medicare beneficiaries for fiscal years 1997 and 1999, linked with information from CMS eligibility, provider, and cost report files as well as the Area Resources File. STUDY DESIGN: Logistic regression was used to estimate the effects of being in the post-BBA period on the incidence of home health service use and ordinary least squares (OLS) regression was used to estimate the effects of being in the post-BBA period on the amount and type of use by home health service users. Interaction terms we reincluded for all the independent variables to assess whether the effect was disproportionate among particular beneficiary subgroups. PRINCIPAL FINDINGS: Results show a 22 percent decrease in the percentage using home health services post-BBA and a 39 percent decrease in the number of visits per user. Stronger reductions, though not very large, were found in the incidence of use for beneficiaries aged 85 and older, those in states with high historical Medicare home health use, and those with Medicaid buy-in. More intensive reductions in the number of services were found for those aged 85 and older, in high historical Medicare use states, nonwhites, females, those using for-profit agencies, and those treated for certain diagnoses. Less intensive reductions were associated with hospital-based agencies. CONCLUSIONS: This research demonstrates that public program expenditures can be sharply curtailed with financial incentives. As reimbursement shifts to a prospective payment system legislated by the BBA, utilization should be closely monitored, especially for vulnerable subgroups.
机译：目的：评估《 1997年预算平衡法案》（BBA）的影响，该法案改变了医疗保险对家庭健康服务的报销方式，对一系列家庭健康利用措施产生了影响，并研究了特定的受益人群是否在不同的受益人群中受到不同的影响。 BBA后时期。数据来源：来自医疗保险和医疗补助服务中心（CMS）标准分析文件的二级数据，用于1997和1999财政年度1％的医疗保险受益人样本，并与CMS资格，提供者和成本报告文件以及区域资源文件。研究设计：Logistic回归用于评估BBA后时期对家庭卫生服务使用发生率的影响，而普通最小二乘（OLS）回归用于评估BBA后时期对家庭健康服务使用的影响。家庭健康服务用户的使用数量和类型。我们对所有自变量都包括了交互作用术语，以评估效果在特定的受益亚组之间是否不相称。主要发现：结果显示，BBA之后使用家庭健康服务的百分比下降了22％，每位用户的访问次数下降了39％。在85岁及以上的受益人，医疗保险历史悠久的州以及医疗补助购买的州，使用率的降低幅度更大，尽管幅度不大。在历史悠久的医疗保险使用州，非白人，女性，使用营利性机构的医疗机构以及接受某些诊断的医疗机构中，发现年龄在85岁及以上的人的服务数量进一步减少。减少程度较轻的减少与医院机构有关。结论：这项研究表明，公共计划的支出可以通过财政激励措施大大减少。随着报销转向BBA立法规定的预期付款系统，应密切监控利用率，尤其是对于弱势群体。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号