Alzheimer's Disease Research Today is a free monthly online journal that collates and summarizes the latest research about Alzheimer's Disease, including details on diagnosis, memory loss, heredity, treatment, medication.

Do financial incentives of introducing case mix reimbursement increase feeding tube use in nursing home residents?

Teno JM, Feng Z, Mitchell SL, Kuo S, Intrator O, Mor V

Center for Gerontology and Health Care Research, Department of Community Health, The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA. Joan_Teno@brown.edu

OBJECTIVES: To determine whether adoption of Medicaid case mix reimbursement is associated with greater prevalence of feeding tube use in nursing home (NH) residents. DESIGN: Secondary analysis of longitudinal administrative data about the prevalence of feeding tube insertion and surveys of states' adoption of case mix reimbursement. SETTING: NHs in the United States. PARTICIPANTS: NH residents at the time of NH inspection between 1993 and 2004. MEASUREMENTS: Facility prevalence of feeding tubes reported at the state inspection of NHs reported in the Online Survey, Certification and Reporting database and interviews with state policy makers regarding the adoption of case mix reimbursement. RESULTS: Between 1993 and 2004, 16 states adopted Resource Utilization Group case mix reimbursement. States varied in the prevalence of feeding tubes in their NHs. Although the use of feeding tube increased substantially over the years of the study, once temporal trends and facility fixed effects were accounted for, case mix reimbursement was not associated with greater prevalence of feeding tube use. CONCLUSION: The adoption of Medicaid case mix reimbursement was not associated with an increase in the prevalence of feeding tube use.

Published 5 May 2008 in J Am Geriatr Soc, 56(5): 887-90.
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