The Shifting Landscape in Utilization of Inpatient, Observation, and Emergency Department Services Across Payers

被引：24

作者：

Nuckols, Teryl K. ^{[1
,2
]}

Fingar, Kathryn R. ^{[3
]}

Barrett, Marguerite ^{[4
]}

Steiner, Claudia A. ^{[5
,6
]}

Stocks, Carol ^{[5
]}

Owens, Pamela L. ^{[5
]}

机构：

[1] RAND Corp, 1776 Main St, Santa Monica, CA 90401 USA

[2] Cedars Sinai, Dept Med, Div Gen Internal Med, Los Angeles, CA USA

[3] Truven Hlth Analyt, Ann Arbor, MI USA

[4] ML Barrett Inc, Del Mar, CA USA

[5] Agcy Healthcare Res & Qual, Rockville, MD USA

[6] Kaiser Permanente Colorado, Denver, CO USA

来源：

JOURNAL OF HOSPITAL MEDICINE | 2017年 / 12卷 / 06期

基金：

美国医疗保健研究与质量局;

关键词：

HOSPITALS;

D O I：

10.12788/jhm.2751

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Recent policies by public and private payers have increased incentives to reduce hospital admissions. Using data from four states from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project, this study compared the payer-specific population-based rates of adults using inpatient, observation, and emergency department (ED) services for 10 common medical conditions in 2009 and in 2013. Patients had an expected primary payer of private insurance, Medicare, Medicaid, or no insurance. Across all four payer populations, inpatient admissions declined, and care shifted toward treat-and-release observation stays and ED visits. The percentage of hospitalizations that began with an observation stay increased. Implications for quality of care and costs to patients warrant further examination. (C) 2017 Society of Hospital Medicine

引用

页码：443 / 446

页数：4

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