Prospective payment system and other effects on post-hospital services

The effects of the prospective payment system and other factors on the use of post-hospital services were investigated for four groups of diagnostically related Medicare discharges. Effects on specific services and total Medicare payments were analyzed at the beneficiary level using a Tobit regression technique. The utilization data base consisted of more than 30,000 discharge episode records for the years 1981-86. The post-hospital period for each Medicare beneficiary encompassed the 60 days following discharge from the hospital. Influences on both the level and timing of health care services during this period were appraised. The influence of the prospective payment system was measured through the financial impact and risk that it imposed on the discharging hospital.