Policy, Politics, & Nursing Practice

 

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Policy, Politics, & Nursing Practice, Vol. 6, No. 1, 39-50 (2005)
DOI: 10.1177/1527154404272608

The Influence of a Change in Medicare Reimbursement on the Effectiveness of Stage III or Greater Decubitus Ulcer Home Health Nursing Care

Melody K. Eaton, Ph.D., M.B.A., R.N.

This study was designed to describe and evaluate the influence of a change in a Medicare reimbursement on the effectiveness of home health nursing care for stage III or greater decubitus ulcer patients. This health policy originated from the Balanced Budget Act (BBA) of 1997 and took its full effect with initiation of the Prospective Payment System (PPS) on October 1, 2000. A quantitative quasi-experimental design used OASIS data from the state of Virginia to evaluate 555 stage III or greater decubitus ulcer patients, age 65 or older. Comparisons were investigated between pre-PPS, 2000, and post-PPS, 2001, outcomes related to reported ulcer healing, lengths of stay, and discharge disposition. Results demonstrated significant differences for the outcomes studied. In addition, sanitation, ulcer healing, and discharge disposition were linked as predictors for length of stay. Results demonstrated that PPS has affected nursing care effectiveness for stage III or greater decubitus ulcer home health patients.

Key Words: home health • Medicare prospective payment • decubitus ulcer care • access to home care • care effectiveness • nursing care • health policy • Balanced Budget Act of 1997 • BBA ‘97


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