Case-mix classification of Medicare residents in skilled nursing facilities: resource utilization groups (RUG-T18)

TitleCase-mix classification of Medicare residents in skilled nursing facilities: resource utilization groups (RUG-T18)
Publication TypeJournal Article
Year of Publication1989
AuthorsFries B.E, Schneider D.P, Foley W.J, Dowling M.
JournalMedical Care
Volume27
Issue9
Pagination843-58
Date PublishedSep
Accession Number2505002
Keywords*Diagnosis-Related Groups/ec [Economics], *Long-Term Care/cl [Classification], *Medicare/ut [Utilization], *Reimbursement Mechanisms, *Skilled Nursing Facilities/ut [Utilization], California, Costs and Cost Analysis/sn [Statistics & Numerical Data], Data Collection, Florida, Health Resources/ut [Utilization], Human, Illinois, New York, Pennsylvania, Skilled Nursing Facilities/ec [Economics], Support, U.S. Gov't, Non-P.H.S., United States
Abstract

Medicare residents in Skilled Nursing Facilities (SNFs) represent a small but unique population about which little is known. Data collected in a national sample of 2,564 Medicare residents in 38 SNFs were used to derive a resident classification system appropriate for use in a payment system. The classification system, Resource Utilization Groups-Medicare (RUG-T18) explains 55.5% of the per-diem resource cost differences of Medicare SNF residents. No classification system could be derived to provide significant explanation of per-episode costs. Although Medicare residents are admitted to SNFs immediately following an acute stay that is paid according to their diagnosis-related groups, the DRGs were ineffective in explaining SNF resource costs.

Short TitleMed CareMed Care
Alternate JournalMed Care