Coping with diagnosis related groups. The changing role of the nursing home. Arch Intern Med 1988 Jun;148(6):1393-6
Date
06/01/1988Pubmed ID
3132122DOI
10.1001/archinte.1988.00380060157028Scopus ID
2-s2.0-0023914133 (requires institutional sign-in at Scopus site) 9 CitationsAbstract
In an attempt to document the changing role of a specific nursing home in the delivery of medical care since the initiation of diagnosis related groups (DRGs), we studied 100 consecutive patients initially admitted to the Veterans Administration Medical Center-Milwaukee Nursing Home Care Unit (NHCU) during the first 23 weeks of 1986 (post-DRGs). Patient characteristics, reason for NHCU admission, and patients' final disposition were determined and compared with those of consecutive patients admitted to the same facility during an identical time period in 1983 (pre-DRGs). More than seven times as many patients were admitted in 1986, and prior to NHCU admission the acute care hospital stay was significantly shorter in 1986 (22 vs 60 days). Whereas in 1983, most patients (94%) were admitted to the NHCU for long-term care placement, in 1986, the majority of patients (64%) were admitted for continuation of therapy started in the acute care hospital. In 1983 only two patients (9%) required hospital readmission within ten days of NHCU admission, compared with 22 (22%) of the patients in 1986. At the termination of the study period, none of the 31 patients admitted to the NHCU in 1983 had been discharged; in comparison, 33% of the patients in 1986 were discharged home. We conclude that in 1986 certain nursing homes drastically changed their role in the delivery of medical care, and are now functioning as extensions of acute care hospitals. Such a role is advantageous in allowing patients to be quickly discharged from the acute care hospital; however, the changing role presents new problems and challenges.
Author List
Tresch DD, Duthie EH Jr, Newton M, Bodin BAuthor
Edmund H. Duthie MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedDelivery of Health Care
Diagnosis-Related Groups
Female
Homes for the Aged
Hospitals, Veterans
Humans
Length of Stay
Male
Nursing Homes
Patient Admission
Patient Readmission
Prospective Studies
Wisconsin
