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National Information Center on Health Services Research and Health Care Technology (NICHSR)

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Introduction to Health Services Research : A Self-Study Course

Case Description | Case Background | Case Objectives | Case Exercise

Case 3. Medicare Reimbursement Reforms (Page 4 of 37)

Case Exercise

Phase One: Thinking About the Issues

Q1. What are the problems or issues inherent in this research case and what are the quality of health care issues?

Q1a. Determine the problems or issues inherent in this research case and and begin to define the questions you need to ask.

Since the person who is sick is assumed to be close to you (your Dad), you might be particularly interested in quality of care issues given that patients are released from the hospital earlier and possibly sicker. You might want to find if early release is indeed a problem.

You might also have concerns about your Dad's quality of life when he arrives home. You might also affected by having to stay home from work to be a caregiver. You might think of a number of questions that you would need to find information on the effects on caregivers.

If, in your role as a professional librarian, you were asked these and related questions by a researcher you will likely find that you will have to answer many other questions as the researcher plans her research project.

How do you plan to get ready to attack this case? What kinds of issues might you think about as you begin thinking about this case?

Your first task will most certainly be to think about the case and read over the background information.

Suggested solution...

Q1b. What are the effects of the Medicare prospective payment reimbursement system on the quality of health care for the elderly? In other words, what are the quality issues in this scenario?

Health services researchers have conducted many investigations about cost savings and the quality of health care for hospitalized Medicare patients under the DRG system. They argue whether prospective payment saved the government money by reducing length of stay and forcing clinicians and hospitals to become more efficient.

On the other hand, many contend that reduced LOS and lower reimbursement rates have produced sicker patients who require readmissions and more nursing home or home health care services.

Suggested solution...

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