Site of death in the hospital versus nursing home of Medicare skilled nursing facility residents admitted under Medicare's Part A Benefit.

Abstract:

OBJECTIVES:To determine factors that predict site of death (hospital vs nursing home (NH)), related costs, and geographic variation in site of death of NH residents admitted under the Medicare Part A Benefit. DESIGN:Retrospective cohort study. SETTING:NHs located in the United States (N=13,146). PARTICIPANTS:All persons admitted to skilled nursing facilities (SNFs) in 2001 who died in a SNF (n=101,307) or hospital (n=51,187). MEASUREMENTS:Patient, facility, and geographic characteristics associated with death in a hospital and receipt of Medicare payment. RESULTS:Absence of a do-not-resuscitate order, non-Caucasian ethnicity, greater functional independence, and higher cognitive status correlated with hospital as the site of death. Rural, hospital-based, and government-owned facilities had the lowest in-hospital death rates. Site of death varied widely from state to state. Of those who died in a hospital, 24.2% (12,410) died within 24 hours of transfer. The average daily combined stay Medicare payment for those who died in the hospital was $969, versus $300 for those who died in a NH. CONCLUSION:Patient and facility characteristics predict site of death of Medicare NH patients, but in-hospital death rather than NH death varies geographically and is associated with higher daily Medicare payment.

journal_name

J Am Geriatr Soc

authors

Levy CR,Fish R,Kramer AM

doi

10.1111/j.1532-5415.2004.52352.x

subject

Has Abstract

pub_date

2004-08-01 00:00:00

pages

1247-54

issue

8

eissn

0002-8614

issn

1532-5415

pii

JGS52352

journal_volume

52

pub_type

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