Trends in Long-Term Acute Care Hospital Use in Texas from 2002-2011.

摘要: Author(s): Makam, Anil N; Nguyen, Oanh K; Zhou, Jie; Ottenbacher, Kenneth J; Halm, Ethan A | Abstract: ObjectiveTo assess regional trends in long-term acute care hospital (LTAC) use over time.Design setting participantsRetrospective study using 100% Texas Medicare data. Separate cohorts were created for each year from 2002-2011, which included all beneficiaries residing 23 referral regions (HRRs) with continuous enrollment Parts and B the previous current year, or until death.MeasurementsLTAC utilization rate was defined as number of individuals a LTAC stay per 100,000 HRR. Baseline at HRR-level categorized by tertiles 2002.ResultsOverall, increased 35% 2002-2011 coincided major policy changes. However, there marked differences trends. From HRRs lowest tertile baseline use, 0 to 1 facilities 2002, had an increase 211%, 190 591 persons. In contrast, highest some most densely LTAC-bedded country, experienced 21% decline (915 719 persons; pl0.001 interaction use).ConclusionThese findings suggest substantial variation time. Further research is needed estimate how much this due clinical need increasing severely ill older adults versus market supply.