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Medical foster home is less costly than traditional nursing home care
Author(s) -
Levy Cari,
Whitfield Emily A.,
Gutman Roee
Publication year - 2019
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13195
Subject(s) - medicine , propensity score matching , health care , veterans affairs , data extraction , health informatics , payment , long term care , inpatient care , medline , medical emergency , family medicine , nursing , gerontology , public health , business , finance , political science , law , economics , economic growth
Objective To compare the costs of Community Nursing Homes (CNHs) to Medical Foster Homes (MFHs) at Veteran Health Administration (VHA) Medical Centers that established MFH programs. Data Sources Episode and costs data were derived from VA and Medicare files (inpatient, outpatient, emergency room, skilled nursing facility, dialysis, and hospice). Study Design Propensity scores matched 354 MFH to 1693 CNH Veterans on demographics, clinical characteristics, health care utilization, and costs. Data Extraction Methods Data were retrieved for years 2010‐2011 from the VA Corporate Data Warehouse, VA Health Data Repository, and the VA MFH Program through the VA Informatics and Computing Infrastructure (VINCI). Principal Findings After matching on unique characteristics of MFH Veterans, costs were $71.28 less per day alive compared to CNH care. Home‐based and mental health care costs increased with savings largely attributable to avoiding CNH residential care. When average out‐of‐pocket payments by Veterans of $74/day are considered, MFH is at least cost neutral. Mortality was 12 percent higher among matched Veterans in CNHs. Conclusions MFHs may serve as alternatives to traditional CNH care that do not increase total costs with mortality benefits. Future work should examine the differences for functional disability subgroups.