JAMDA
Volume 10, Issue 9 , Pages 644-652 , November 2009

Reducing Potentially Avoidable Hospitalizations of Nursing Home Residents: Results of a Pilot Quality Improvement Project

  • Joseph G. Ouslander, MD

      Affiliations

    • The Charles E. Schmidt College of Biomedical Sciences and the Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL
    • Division of Gerontology and Geriatric Medicine, Department of Medicine, the University of Miami Miller School of Medicine, Miami, FL
    • Corresponding Author InformationAddress correspondence to Joseph G. Ouslander, MD, The Charles E. Schmidt College of Biomedical Sciences, Florida Atlantic University, 777 Glades Road, Bldg 71, Boca Raton, FL 33431.
    • ,
  • Mary Perloe, MS, GNP

      Affiliations

    • The Georgia Medical Care Foundation, Atlanta, GA
    • ,
  • JoVonn H. Givens, MPH

      Affiliations

    • The Georgia Medical Care Foundation, Atlanta, GA
    • ,
  • Linda Kluge, RD, LD, CPHQ

      Affiliations

    • The Georgia Medical Care Foundation, Atlanta, GA
    • ,
  • Tracy Rutland, MBA, MHA

      Affiliations

    • The Georgia Medical Care Foundation, Atlanta, GA
    • ,
  • Gerri Lamb, PhD, RN

      Affiliations

    • Arizona State University College of Nursing & Healthcare Innovation, Tuscon, AZ

References 

  1. Saliba D, Kington R, Buchanan J, et al. Appropriateness of the decision to transfer nursing facility residents to hospital. J Am Geriatr Soc. 2000;48:154–163
  2. Grabowski DC, O'Malley AJ, Barhydt NR. The costs and potential savings associated with nursing home hospitalizations. Health Affairs. 2007;26:1753–1761
  3. Walker JD, Teare GF, Hogan DB, et al. Identifying potentially avoidable hospital admissions from Canadian long-term care facilities. Med Care. 2009;47:250–254
  4. Department of Health & Human Services, Centers for Medicare and Medicaid Services. Medicare Nursing Home Value-Based Purchasing Initiative. November 14, 2008. Baltimore, MD:, SMDL #08–009.
  5. Ouslander JG. Paying for performance in nursing homes: Don't throw the baby out with the bathwater. J Am Geriatr Soc. 2008;56:1959–1962
  6. http://www.qualitynet.org/dcs/ContentServer?cid=1211554364427&pagename=Medqic/MQTools/ToolTemplate&c=MQTools. Accessed May 16, 2009.
  7. Grabowski DC. Medicare and Medicaid: Conflicting incentives for long-term care. Milbank Q. 2007;85:579–610
  8. Ouslander JG, Weinberg AD, Phillips V. Inappropriate hospitalization of nursing facility residents: A symptom of a sick system of care for frail older people. J Am Geriatr Soc. 2000;48:230–231
  9. Davis K. Paying for care episodes and care coordination. N Engl J Med. 2007;356:1166–1168
  10. Medicare Payment Advisory Commission. A path to bundled payment around a hospitalization. Report to the Congress: Reforming the Delivery System, Chapter 4, pp 83–103, Washington, DC, June, 2008.
  11. Ackermann RJ, Kemle KA. The effect of a physician assistant on the hospitalization of nursing home residents. J Am Geriatr Soc. 1998;46:610–614
  12. Rueben D, Buchanan J, Farley D, et al. Primary care of long-stay nursing home residents: A comparison of 3 HMO programs with fee-for-service care. J Am Geriatr Soc. 1999;47:131–138
  13. Wieland D, Lamb VL, Sutton SR, et al. Hospitalization in the Program of All-Inclusive Care for the Elderly (PACE): Rates, concomitants, and predictors. J Am Geriatr Soc. 2000;48:1373–1380
  14. Kane RL, Keckhafer G, Flood S, et al. The effect of Evercare on hospital use. J Am Geriatr Soc. 2003;51:1427–1434
  15. Briesacher B, Field T, Baril J, Gurwitz J. Can pay-for-performance take nursing home care to the next level?. J Am Geriatr Soc. 2008;56:1937–1939

 This project was supported by a contract (Contract # APP-PSS614) from the Centers for Medicare and Medicaid Services (CMS) to the Georgia Medical Care Foundation (GMCF). CMS had the opportunity to review this manuscript, and the opinions presented do not necessarily reflect those of CMS of GMCF. None of the authors have any financial conflicts of interest with regard to this article.

PII: S1525-8610(09)00248-5

doi: 10.1016/j.jamda.2009.07.001

JAMDA
Volume 10, Issue 9 , Pages 644-652 , November 2009

Article Tools