Examining Healthcare Expenditures: Mechanical Ventilation & An Evaluation of Long-Term (Acute) Care Hospitals

Abstract

This study analyzed demographic and clinical characteristics, actual hospital/facility costs, and Medicare charges/payments among beneficiaries discharged to, and from, long-term (acute) care hospitals (LTCHs), skilled nursing facilities (SNFs), or inpatient rehabilitation facilities (IRFs) following an acute inpatient hospitalization under Medicare-severity diagnosis-related group (MS-DRG) 207, "respiratory system diagnosis with ventilator support for greater than 96 hours." We also examined the likelihood of discharge by provider type to determine criteria informing patient discharge to a LTCH, SNF, or IRF for treatment.

Concerning discharges to LTCHs, patients were not significantly older, did not have the highest length of stay, and had comparable diagnoses and diagnosis counts to those discharged elsewhere. Discharges from LTCHs had significantly higher diagnosis counts and lengths of stay. Costs, charges, and payments were significantly higher among discharges to, and from, LTCHs. Multinomial logistic regression analyses indicated numerous associations between certain variables and discharge location.