PDF(Pubmed)
Abstract：
This study investigated the association between Medicaid Home and Community-Based Services (HCBS) generosity and post-discharge outcomes among dual-eligible beneficiaries discharged from skilled nursing facilities (SNFs). We linked multiple national datasets for duals discharged from SNFs between 2010 and 2013. Accounting for SNF fixed effects, we estimated the effect of HCBS generosity, measured by its breadth and intensity, on the likelihood of remaining in the community, risks of death, nursing home (NH) admission, and hospitalizations within 30 and 180 days after SNF discharge. We found that higher HCBS generosity was associated with an increased likelihood of remaining in the community. HCBS breadth and intensity were both significantly associated with reduced risks of NH admission, while higher HCBS intensity was related to a reduced risk of acute hospitalizations within 30 days after discharge. Our findings suggest that more generous HCBS programs may facilitate smoother transitions and sustainable community living following SNF discharge.
摘要：
这项研究调查了从熟练护理机构（SNFs）出院的双重资格受益人的医疗补助家庭和社区服务（HCBS）慷慨与出院后结果之间的关联。我们链接了2010年至2013年间从SNF释放的双重数据的多个国家数据集。考虑SNF固定效应，我们估计了HCBS慷慨的影响，以它的宽度和强度来衡量，关于留在社区的可能性，死亡的风险,疗养院（NH）入院，以及在SNF出院后30和180天内住院。我们发现，较高的HCBS慷慨与留在社区的可能性增加有关。HCBS的宽度和强度均与降低NH入院风险显着相关，而较高的HCBS强度与出院后30天内急性住院风险降低有关.我们的发现表明，更慷慨的HCBS计划可能会在SNF出院后促进更顺利的过渡和可持续的社区生活。
