David C. Grabowski is the principal investigator and the contact person for this project.

A decrease in the hospitalization of nursing home residents has been an important policy goal for several decades. Nursing home residents often develop iatrogenic and nosocomial disease in the hospital setting and return to the nursing home functionally and cognitively more impaired than when they entered the hospital. Many hospitalizations may potentially be prevented through treatment within the nursing home setting, and because the hospital setting is much more costly, there is also the potential to lower costs when unnecessary hospitalizations are avoided.

The New York State Department of Health has recently become interested in exploring alternative methods of paying nursing homes in an effort to decrease unnecessary hospitalizations. In a partnership between New York State and Harvard Medical School, this project analyzes the costs (and potential savings) associated with nursing home hospitalizations, predictors of nursing home hospitalizations, outcomes for nursing home residents with and without hospital transfer, and the implications of different payment models for nursing home hospitalizations. The project makes use of a unique data linkage between the nursing home minimum data set (MDS) and the Statewide Planning and Research Cooperative System (SPARCS) hospital inpatient dataset. This research is expected to result in a proposed payment model to reduce health care costs and improve the quality of nursing home care, while also providing a model program that can be replicated nationally.