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Related Experiment Videos

Resource utilization groups. DRGs move to long-term care.

E L Mitty1

  • 1Jewish Institute for Geriatric Care, New Hyde Park, New York.

The Nursing Clinics of North America
|September 1, 1988
PubMed
Summary
This summary is machine-generated.

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New York State

Area of Science:

  • Healthcare Economics
  • Geriatric Care
  • Nursing Management

Background:

  • Rising elderly population and escalating acute care costs necessitate cost-effective long-term care solutions.
  • Development of a prospective payment system (PPS) for institutional long-term care in New York State.
  • Resource Utilization Groups (RUGs) are emerging as a national model for long-term care reimbursement.

Purpose of the Study:

  • To describe the Resource Utilization Groups (RUGs) prospective payment system for institutional long-term care in New York State.
  • To analyze the impact of RUGs on patient care, nursing practice, and discharge planning.
  • To identify challenges and opportunities for nursing within the RUGs framework.

Main Methods:

  • The RUGs system classifies patients into 16 case-mix groups based on Activities of Daily Living (ADL) assessments.

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  • Reimbursement rates are determined by a formula combining direct care, medical, and ancillary costs.
  • Nursing documentation of patient care and resource utilization is crucial for RUGs classification.

    • Main Results:

    • RUGs reimbursement is based on patient case-mix, not diagnosis, age, or length of stay.
    • Patients requiring light care may face admission denial or be discharged to community settings.
    • Discharge planning and patient teaching for less dependent living are becoming integral to nursing home care.

    Conclusions:

    • Nurses must manage technologically dependent patients and prepare them for discharge.
    • Key challenges for nursing include mitigating negative incentives within RUGs, analyzing nursing process and productivity.
    • Further research is needed to observe the effect of the RUGs reimbursement system on the quality of care.