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  • A Comparison of Outcomes between a High-Volume and Other Long-Term Care Hospitals in the Chicago Market: An Examination of Patients on Prolonged Mechanical Ventilation

    Long-term care hospitals (LTCHs) are an important post-acute care setting for patients who receive prolonged mechanical ventilation (PMV).  RML Specialty Hospital (RML), with campuses in Chicago and Hinsdale, IL, is an LTCH that cares for a disproportionate share of PMV patients in Chicago area.  In this study, we compare mortality, readmissions and Medicare payments for PMV patients treated in RML versus other LTCHs in the Chicago area.  The study population consisted of Medicare beneficiaries who experienced a STACH stay with PMV (MS-DRG: 3, 4) between March 2011 and June 2013 in the Chicago area and discharged to an LTCH.  Patients who discharged to RML immediately following the STACH stay constituted the treatment group.  We used propensity score matching to construct a comparison group consisting of patients with similar characteristics receiving care in other LTCHs after a STACH stay.  Among patients who were discharged with MS-DRG 3 from a STACH, those treated in RML had lower mortality and Medicare payments over 180-day episodes starting with admission to the STACH (p<0.05) compared to similar patients treated in other regional LTCHs.  RML patients with a STACH MS-DRG of 4 had similar 180-day mortality (p>0.05) but lower 180-day Medicare payments (p<0.05) compared to similar patients treated in other regional LTCHs.  The differences in readmission rates between RML patients and similar patients cared for in other regional LTCHs were not statistically significant (p>0.05).

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    Services : Health Economics & Outcomes Research Expertise: , ,

    Long-term care hospitals (LTCHs) are an important post-acute care setting for patients who receive prolonged mechanical ventilation (PMV).  RML Specialty Hospital (RML), with campuses in Chicago and Hinsdale, IL, is an LTCH that cares for a disproportionate share of PMV patients in Chicago area.  In this study, we compare mortality, readmissions and Medicare payments for

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  • A Regional Analysis of Patient Outcomes and Medicare Payments for Sepsis Patients Treated in Long-Term Care Hospitals and Skilled Nursing Facilities

    In this study, we compare mortality, readmissions and Medicare payments for long-term care hospital (LTCH) patients who had a short-term acute care hospital (STACH) stay for sepsis and similar patients cared for in SNFs in the Chicago area. The study population consisted of Medicare beneficiaries who experienced an STACH stay for septicemia or severe sepsis (MS-DRG: 870, 871) between March 2011 and June 2013 in the Chicago area and were discharged to an LTCH or SNF.  Patients who were discharged to LTCHs immediately following the STACH stay constituted the treatment group.  We used propensity score matching to construct a comparison group consisting of patients with similar characteristics receiving care in SNFs after the STACH stay.  We did not find statistically significant differences in mortality and Medicare payments between LTCH and SNF patients over 180-day episodes of care that started at admission to STACH (p>0.05).  However, LTCH patients experienced lower readmission rates within 30-days after discharge from STACH when compared to SNF patients (LTCH patients: 14% vs. SNF patients: 29%, p<0.05).  The difference in 60- and 90-day readmission rates between the two groups is statistically insignificant (p>0.05).

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    Services : Health Economics & Outcomes Research Expertise: , ,

    In this study, we compare mortality, readmissions and Medicare payments for long-term care hospital (LTCH) patients who had a short-term acute care hospital (STACH) stay for sepsis and similar patients cared for in SNFs in the Chicago area. The study population consisted of Medicare beneficiaries who experienced an STACH stay for septicemia or severe sepsis

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  • A Comparative Effectiveness Analysis of Care Received in a Long-Term Care Hospitals

    In recent years, there has been increasing interest in assessing the value of long-term care hospitals (LTCHs) to Medicare beneficiaries as researchers have observed that the LTCH patient population overlaps both with patients treated in step-down units of acute care hospitals and other settings. KNG Health conducted a comparative-effectiveness study of LTCH care using a quasi-experimental study design and Medicare inpatient claims data.  Among patients with multiple organ failure, the study reported lower mortality at similar or lower Medicare payment or lower Medicare payment at similar mortality in 4 of the 5 condition categories studied for patients cared for in an LTCH as compared to patients cared for at other settings. For patients with 3 or more days in an intensive care unit, LTCH care was associated with better outcomes in 3 of the 5 condition categories and ambiguous results for the remaining 2 categories (LTCH care is associated with lower mortality at higher Medicare payment).  The study results were published in Medical Care.

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    Services : Health Economics & Outcomes Research Expertise: , ,

    In recent years, there has been increasing interest in assessing the value of long-term care hospitals (LTCHs) to Medicare beneficiaries as researchers have observed that the LTCH patient population overlaps both with patients treated in step-down units of acute care hospitals and other settings. KNG Health conducted a comparative-effectiveness study of LTCH care using a

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