Paper
Wednesday, 19 July 2006
This presentation is part of : Evidence-Based Practice Implications for Public Policy
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, PhD, MBA, RN, Nursing, James Madison University, Harrisonburg, VA, USA
Learning Objective #1: Discuss the impact that a change in health policy has on home health nursing care effectiveness.
Learning Objective #2: Distinguish whether access to home health care and resulting wound care outcomes are linked to a change in Medicare reimbursement.
This study was designed to describe and evaluate the impact of a change in a Medicare reimbursement program 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 was used to evaluate 555 Virginia stage III or greater decubitus ulcer patients, age 65 or older, from a secondary data base (OASIS) to compare pre PPS and post PPS outcomes related to reported ulcer healing status, lengths of stay, and discharge disposition. Data were re-coded, cleaned, and analyzed using SAS/ SPSS software, and descriptive, bivariate, and multivariate regression techniques. Results demonstrated significant differences for the three outcomes studied. In addition, sanitation, ulcer healing status and discharge disposition were linked as predictors for length of stay in home health. In conclusion, results demonstrated that a health policy, The Balanced Budget Act of 1997, has impacted nursing care effectiveness for stage III or greater decubitus ulcer home health patients.

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