Home care may not cut hospital spending
Study also finds wide reimbursement variation
The provision of home care services doesn't necessarily reduce hospital spending on inpatient services, a new study has found.
Although it is commonly assumed that home care services are used to take the place of some inpatient services, the study "The Dartmouth Atlas of Health Care," did not find this to be the case.
"Though this substitution effect might exist in a few localities, we didn't find this to be the norm," says Megan Cooper, editor of the study.
The atlas is an analysis of nationwide Medicare data from 1993, conducted by John E. Wennberg, MD, MPH, physician and epidemiologist at Dartmouth Medical School in Hanover, NH, and the director of Dartmouth's Center for the Evaluative Clinical Sciences.
Cost can be 25 times more in a region
The study also found that the cost for home care reimbursement can vary by as much as 25 times across the country. "The data show astonishing differences in price-adjusted reimbursement by region," Cooper says.
For example, regional Medicare reimbursement for home care, when adjusted for price, costs as much as $1,292 per person in Chattanooga, TN, and as little as $51 per person in Rochester, MN.
More information about the home care industry will be available when the atlas is published in April by the American Hospital Association (AHA). The study will be available to the public after April 30, 1996. To order the study, call the AHA at (800) 242-2626. The catalog number of the study is 044100.
In the meantime, portions of the study are available on the World Wide Web: http://www.dartmouth.edu/~atlas/ *
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