OBJECTIVES: To determine the effect of a Social Health Maintenance Organization (S/HMO) on diverting older adults admitted into a nursing facility from converting to long-stay placement. DESIGN: Members of the SCAN S/HMO and those in Medicare Fee-For-Service were compared on successful discharge to the community after being admitted to nursing facilities between January 1, 2001, and December 31, 2003. SETTING: Skilled nursing facilities in 4 counties in Southern California (Los Angeles, Orange, San Bernardino, Riverside). PARTICIPANTS: Data (N = 4635) were extracted from Minimum Data Set (MDS) 2.0 records for nursing facility residents in the S/HMO or the Medicare Fee-for-Service 5% sample who were aged 65 and older with an episode of care greater than 14 days. MEASUREMENTS: Predisposing, enabling, and need measures were used to predict successful discharge to the community within 90 days. RESULTS: After controlling for selected sociodemographics, comorbidities, behavioral issues, mental health conditions, and other risk factors, being enrolled in the S/HMO increased the likelihood of successful discharge by 26%. CONCLUSION: With systemic increases in short-stay patients, research on diversion must look past the avoidance of unnecessary entry to nursing facilities, to the successful transition of short-stay residents to the community. As described in this study, the S/HMO model is an important but largely unaddressed method of avoiding the conversion to long-stay. Copyright 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
OBJECTIVES: To determine the effect of a Social Health Maintenance Organization (S/HMO) on diverting older adults admitted into a nursing facility from converting to long-stay placement. DESIGN: Members of the SCAN S/HMO and those in Medicare Fee-For-Service were compared on successful discharge to the community after being admitted to nursing facilities between January 1, 2001, and December 31, 2003. SETTING: Skilled nursing facilities in 4 counties in Southern California (Los Angeles, Orange, San Bernardino, Riverside). PARTICIPANTS: Data (N = 4635) were extracted from Minimum Data Set (MDS) 2.0 records for nursing facility residents in the S/HMO or the Medicare Fee-for-Service 5% sample who were aged 65 and older with an episode of care greater than 14 days. MEASUREMENTS: Predisposing, enabling, and need measures were used to predict successful discharge to the community within 90 days. RESULTS: After controlling for selected sociodemographics, comorbidities, behavioral issues, mental health conditions, and other risk factors, being enrolled in the S/HMO increased the likelihood of successful discharge by 26%. CONCLUSION: With systemic increases in short-stay patients, research on diversion must look past the avoidance of unnecessary entry to nursing facilities, to the successful transition of short-stay residents to the community. As described in this study, the S/HMO model is an important but largely unaddressed method of avoiding the conversion to long-stay. Copyright 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.
Authors: V Mor; K Branco; J Fleishman; C Hawes; C Phillips; J Morris; B Fries Journal: J Gerontol B Psychol Sci Soc Sci Date: 1995-01 Impact factor: 4.077