Findings in the Area of Managed Care Reported from Yale University School of Medicine (Association of Psychiatric Diagnoses and Medicaid Coverage With Length of Stay Among Inpatients Discharged To Skilled Nursing Facilities): Managed Care

2023 OCT 27 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Current study results on Managed Care have been published. According to news reporting out of New Haven, Connecticut, by NewsRx editors, research stated, “Inpatients with psychiatric diagnoses often require higher levels of care in skilled nursing facilities (SNFs) and are more likely to be covered by Medicaid, which reimburses SNFs at significantly lower rates than Medicare and commercial payors. To characterize factors affecting length of stay in inpatients discharged to SNFs.”

Our news journalists obtained a quote from the research from the Yale University School of Medicine, “A retrospective cross-sectional study design using 2016-2018 data from National Inpatient Sample. Inpatients aged >= 40 who were discharged to SNFs. EXPOSURES: Primary discharge diagnosis (medical, psychiatric, or substance use) and primary payor. AND MEASURES: Length of stay, categorized non-exclusively as >3 days, >7 days, or > 14 days. Among 9,821,155 inpatient discharges to SNFs between 2016 and 2018, 95.7% had medical primary discharge diagnoses, 3.3% psychiatric diagnoses, and 1.0% substance use diagnoses; Medicare was the most common primary payor (83.3%), followed by private insurance (7.9%), Medicaid (6.6%), and others (2.2%). Median length of stay for all patients was 5.0 days (interquartile range [IQR], 3.0-8.0), 5.0 (IQR, 3.0-8.0) for those with medical diagnoses, 8.0 (IQR, 4.0-15.0) for psychiatric diagnoses, and 5.0 (IQR, 3.0-8.0) for substance use diagnoses. After multivariable adjustment, compared to patients with medical diagnoses, patients with psychiatric diagnoses were more likely to have hospital stays > 3, > 7, and > 14 days, respectively (p < 0.001). Compared to Medicare patients, Medicaid patients were more likely to have hospital stays > 3, > 7, and > 14 days, respectively (p < 0.001). Compared to patients with medical diagnoses, those with psychiatric diagnoses were also more likely to have lengths of stay 1 times, 1.5 times, and 2 times greater than the national geometric mean length of stay for that diagnosis-related group (p < 0.001).”

According to the news editors, the research concluded: “Patients discharged to SNFs after inpatient hospitalization for psychiatric diagnoses and with Medicaid coverage were more likely to have longer lengths of stay than patients with medical diagnoses and those with Medicare coverage, respectively.”

This research has been peer-reviewed.

For more information on this research see: Association of Psychiatric Diagnoses and Medicaid Coverage With Length of Stay Among Inpatients Discharged To Skilled Nursing Facilities. Journal of General Internal Medicine, 2022;37(12):3070-3079. Journal of General Internal Medicine can be contacted at: Springer, One New York Plaza, Suite 4600, New York, Ny, United States. (Wiley-Blackwell - http://www.wiley.com/; Journal of General Internal Medicine - http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1525-1497)

Our news journalists report that additional information may be obtained by contacting Taeho Greg Rhee, Yale University School of Medicine, Dept. of Psychiatry, New Haven, CT, United States. Additional authors for this research include Victoria L. Bartlett, Joseph S. Ross and Lilanthi Balasuriya.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1007/s11606-021-07320-4. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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