ABSTRACT
Using multivariate analysis, this study evaluates the relationship between socioeconomic status and hospital resource utilization as measured by length of stay for elderly Medicare patients, age 65 and older, within Shelby County, Tennessee. Variations in length of stay are compared across income groupings for seven different Diagnosis Related Groups (DRGs) and relative effects are measured for socioeconomic status, age, race, gender, discharge status, and severity of illness. Despite the lack of provider specific and patient specific information, the analysis does suggest that, once patients access the medical care system, socioeconomic status has a limited effect on discharge decisions. The results also indicate that the effect of administratively necessary days on length of stay needs further policy review.
Subject(s)
Diagnosis-Related Groups/statistics & numerical data , Hospitals/statistics & numerical data , Length of Stay/statistics & numerical data , Medicare/statistics & numerical data , Aged , Catchment Area, Health , Data Collection , Diagnosis-Related Groups/classification , Humans , Length of Stay/economics , Multivariate Analysis , Poverty , Societies, Hospital , Socioeconomic Factors , Tennessee , United States , Utilization Review/statistics & numerical dataABSTRACT
Attitude surveys of registered nurses were conducted in 1984 (just prior to implementation of prospective payment) and in 1989 (after implementation of changes responsive to prospective payment and increased competition) in an academic medical center. Results indicate more negative attitudes toward hospital administration, pay and promotional opportunities in 1989. However, overall job satisfaction, job variety, job market alternatives, participation in decision making, and intention to leave were unchanged while job variety and perceptions of job market alternatives were more positive in 1989. Implications for health-care management and future research are discussed.
