dc.contributor.author	Hockenberry, Jason M.
dc.contributor.author	Mutter, Ryan
dc.contributor.author	Barrett, Marguerite
dc.contributor.author	Parlato, Judy
dc.contributor.author	Ross, Michael A.
dc.date.accessioned	2021-07-15T15:47:38Z
dc.date.available	2021-07-15T15:47:38Z
dc.date.issued	2013-12-18
dc.description.abstract	Background Patients are treated using observation services (OS) when their care needs exceed standard outpatient care (i.e., clinic or emergency department) but do not qualify for admission. Medicare and other private payers seek to limit this care setting to 48 hours. Data Source/Study Setting Healthcare Cost and Utilization Project data from 10 states and data collected from two additional states for 2009. Study Design Bivariate analyses and hierarchical linear modeling were used to examine patient- and hospital-level predictors of OS stays exceeding 48 (and 72) hours (prolonged OS). Hierarchical models were used to examine the additional cost associated with longer OS stays. Principal Findings Of the 696,732 patient OS stays, 8.8 percent were for visits exceeding 48 hours. Having Medicaid or no insurance, a condition associated with no OS treatment protocol, and being discharged to skilled nursing were associated with having a prolonged OS stay. Among Medicare patients, the mean charge for OS stays was $10,373. OS visits of 48–72 hours were associated with a 42 percent increase in costs; visits exceeding 72 hours were associated with a 61 percent increase in costs. Conclusion Patient cost sharing for most OS stays of less than 24 hours is lower than the Medicare inpatient deductible. However, prolonged OS stays potentially increase this cost sharing.	en_US
dc.description.uri	https://onlinelibrary.wiley.com/doi/full/10.1111/1475-6773.12143	en_US
dc.format.extent	3 files	en_US
dc.genre	journal articles	en_US
dc.identifier	doi:10.13016/m27jdu-vyp7
dc.identifier.citation	Hockenberry, Jason M. et al.; Factors Associated with Prolonged Observation Services Stays and the Impact of Long Stays on Patient Cost; Health Services Research, 49, 3, p 893-909, 18 December, 2013; https://doi.org/10.1111/1475-6773.12143	en_US
dc.identifier.uri	https://doi.org/10.1111/1475-6773.12143
dc.identifier.uri	http://hdl.handle.net/11603/21932
dc.language.iso	en_US	en_US
dc.publisher	Wiley Online Library	en_US
dc.relation.isAvailableAt	The University of Maryland, Baltimore County (UMBC)
dc.relation.ispartof	UMBC School of Public Policy Collection
dc.rights	This item is likely protected under Title 17 of the U.S. Copyright Law. Unless on a Creative Commons license, for uses protected by Copyright Law, contact the copyright holder or the author.
dc.rights	Public Domain Mark 1.0	*
dc.rights	This work was written as part of one of the author's official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.
dc.rights.uri	http://creativecommons.org/publicdomain/mark/1.0/	*
dc.title	Factors Associated with Prolonged Observation Services Stays and the Impact of Long Stays on Patient Cost	en_US
dc.type	Text	en_US

Factors Associated with Prolonged Observation Services Stays and the Impact of Long Stays on Patient Cost

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