Experton B, Branch LG, Ozminkowski RJ, Li Z.

AHSR FHSR Annu Meet Abstr Book. 1996; 13: 49-50.

Humetrix, Inc., San Diego, CA 92122, USA.

RESEARCH OBJECTIVES: This study funded by the John A. Hartford Foundation examines whether total and preventable hospital readmissions among frail elders vary by payor/provider type. STUDY POPULATION: 450 frail elders aged 65+ who received physician-prescribed home care services, responded to the baseline and follow-up surveys, did not change payor/provider type, and who survived the 18-month study period. This analytical sample included 137 Medicare fee-for-service (FFS) beneficiaries, 200 Medicaire HMO enrollees, and 113 dually enrolled Medicare-Medicaid participants. STUDY DESIGN: Hospital readmissions were defined as any hospital admission occurring within 90 days of the index hospital discharge. Preventability of readmissions was evaluated by blind clinical review. Multivariate regression analyses were conducted to determine the impact of payor/provider type on total and preventable readmissions, adjusting for baseline differences. PRINCIPAL FINDINGS: Regression analysis conducted for the entire participant sample showed that Medicare HMO enrollees were 4.16 times as likely to have one or more hospital readmissions and 3.58 times as likely to have preventable hospital readmissions than Medicare FFS participants to have both hospital readmissions and preventable hospital readmissions. The HMO appears to have served frail elderly enrollees who experience hospitalization in ways that increase -- rather than reduce -- subsequent total and preventable hospital readmissions. RELEVANCE TO POLICY, HEALTH CARE DELIVERY AND PRACTICE: HMO providers should focus their attention upon the causes of preventable hospital readmissions of their frail elderly enrollees, and strive to reduce readmission rates of their frail enrollees to at least equal that of the FFS sector.

Publication Types:

• Meeting Abstracts

Keywords:

• Aged
• Data Collection
• Fee-for-Service Plans
• Frail Elderly
• Health Maintenance Organizations
• Home Care Services
• Hospitalization
• Humans
• Medicaid
• Medicare
• Patient Readmission
• economics
• hsrmtgs

Other ID:

• HTX/97604274

UI: 102222176

From Meeting Abstracts