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What happens when hospital-based skilled nursing facilities close? A propensity score analysis
Chapin White1, Susanne Seagrave
1Congressional Budget Office, Washington, DC 20515, USA.
Health Services Research
|December 13, 2005
Summary
Hospital-based skilled nursing facility (HBSNF) closures increased postacute care use and Medicare spending but did not adversely affect patient mortality or rehospitalization rates.
Area of Science:
- Health Services Research
- Geriatric Care
- Healthcare Policy
Background:
- Hospital-based skilled nursing facilities (HBSNFs) provide essential postacute care.
- HBSNF closures can impact healthcare delivery and patient outcomes.
Purpose of the Study:
- To evaluate the impact of HBSNF closures on Medicare beneficiaries.
- Assessed changes in healthcare utilization, spending, and health outcomes.
Main Methods:
- Utilized Medicare fee-for-service claims and provider data (1997-2002).
- Compared hospitals that closed HBSNFs with those that did not.
- Employed propensity score stratification for robust analysis.
Main Results:
- HBSNF closures led to increased use of alternative postacute care settings.
- Associated with longer acute care hospital stays and slightly higher Medicare spending.
- No significant changes observed in mortality or rehospitalization rates.
Conclusions:
- HBSNF closures shift postacute care utilization patterns.
- Closures do not appear to negatively impact patient health outcomes.