Browsing by Subject "Medicare reimbursement"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Older Patients’ Perceptions of Nurse Caring Behaviors
    (Office of the Vice Chancellor for Research, 2013-04-05) Poynter, Melanie A.
    Because patient satisfaction impacts Medicare reimbursement for hospitals today, it is important to look at factors that affect patient satisfaction and patient perceptions of caring. Old-old and oldest old populations are vastly growing and make up the majority of those receiving Medicare benefits. Current research supports older adults’ greater need for relational aspects of care, but little focus has been placed on the effect of non-modifiable factors such as age and education level and perceived health related to patient perceptions of nurse caring behaviors. The purpose of this study was to determine relationships between age, education level, and perceived health and older adult’s perceptions of nurse caring behaviors. A secondary analysis was conducted using data from a quantitative study of nurse caring behaviors using the Caring Assessment Tool (CAT). Of 321 subjects in the original study, s sub-sample of 45 adults age 75 and older who reported education level and perceived health were included. Descriptive statistics and ANOVA were used to analyze the data. Statistical significance was found on the relationship between education and patient CAT scores (p=.003). There was no significant relationship between patient’s perceived health or age and CAT score (p= 0.8). These results show that there is importance in non-modifiable factors, specifically education, when looking at patient perceptions of nurse caring which could impact patient satisfaction scores. Because education is a non-modifiable patient characteristic, healthcare providers must focus on ways to address hospitalized older adult patients’ needs with education levels in mind. Future implications include devising interventions for nurses and other health care staff to improve care for patients of all education levels and how interventions effect patient perceptions of nurse caring. Further study about patients’ perceptions of care is indicated to identify specific needs of patients with varied education levels and their perceptions of nursing care.
  • Thumbnail Image
    Item
    Time Required for Planned and Unplanned Episodes of Care in Septic Two-Stage Revision Hip and Knee Arthroplasty
    (Elsevier, 2022-04) Hulsman, Luci A.; Ziemba-Davis, Mary; Hicks, Shelly A.; Meneghini, R. Michael; Buller, Leonard T.; Orthopaedic Surgery, School of Medicine
    Background Septic revision total hip (rTHA) and knee (rTKA) arthroplasty requires more effort but is reimbursed less than primary procedures per minute of intraoperative time. This study quantified planned and unplanned work performed by the surgical team for septic 2-stage revision surgeries during the entire episode-of-care “reimbursement window” and compared that time to allowable reimbursement amounts. Methods Between October 2010 and December 2020 all unilateral septic 2-stage rTHA and rTKA procedures performed by a single surgeon at a single institution were retrospectively reviewed. Time dedicated to planned work was calculated over each episode of care, from surgery scheduling to 90 days postoperatively. Impromptu patient inquiries and treatments after discharge, but within the episode of care, involving the surgeon/surgeon team constituted unplanned work. Planned and unplanned work minutes were summed and divided by the number of patients reviewed to obtain average minutes of work per patient. Results Sixty-eight hips and 64 knees were included. For 2-stage rTHA and rTKA the average time per patient for planned care was 1728 and 1716 minutes and for unplanned care was 339 and 237 minutes. Compared to the Centers for Medicare and Medicaid Services’ allowable reimbursement times, an additional 799 and 887 minutes of uncompensated time was required to care for 2-stage rTHA and rTKA patients. Conclusion Two-stage revision procedures are substantially more complex than primary procedures. Financially disincentivizing surgeons to care for these patients reduces access to care when high-quality care is most needed. These findings support increasing the allowable times for 2-stage septic revision cases.