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State preadmission screening programs for controlling utilization of long-term care.

C L Polich, L H Iversen

Health Care Financing Review

|March 5, 1988

Summary

State-administered nursing home preadmission screening (PAS) programs may inadvertently increase long-term care utilization. Ineffective screening due to late intervention and limited alternatives hinders effective utilization control.

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Area of Science:

Health Services Research
Gerontology
Public Policy

Background:

State-administered nursing home preadmission screening (PAS) programs are implemented to manage long-term care (LTC) utilization.
The effectiveness of these programs in controlling LTC use is under scrutiny.

Purpose of the Study:

To evaluate whether state-administered PAS programs effectively control the utilization of long-term care.
To identify factors contributing to the potential ineffectiveness of PAS programs.

Main Methods:

Exploratory analysis of the effectiveness of preadmission screening programs.
Review of factors influencing the utilization of long-term care services.

Main Results:

Preadmission screening (PAS) may be increasing, rather than decreasing, long-term care utilization.

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Ineffectiveness is linked to late intervention in the placement process, insufficient alternatives, inadequate risk assessment tools, and conflicting stakeholder goals.

Conclusions:

Current PAS programs may not be an effective strategy for controlling long-term care utilization.
Recommendations include clearer program goal definition and integration of screening within managed-care systems to improve effectiveness.