TABLE 1.
Panel Data Fixed-Effects Regression Analysis—Medicaid Policy and Rates and NH Hospice Usea
| Variables of Interest | Urban (N=42,902) Coef (95% CI) |
Rural Adjacent to Urban (N=11,364) Coef (95% CI) |
Rural Not Adjacent to Urban (N=6,713) Coef (95% CI) |
|---|---|---|---|
| Medicaid rate (a $10 increase) | 0.41 (0.275, 0.553)* | 0.11 (−0.144, 0.368) | −0.37 (−0.676, −0.063)‡ |
| Medicaid case-mix reimbursement (introduction) | 2.14 (1.388, 2.896)* | 2.06 (1.033, 3.095)* | 1.74 (0.350, 3.126)‡ |
| Secular Trends | |||
| Per year | 3.03 (2.864, 3.198)* | 2.75 (2.392, 3.109)* | 2.30 (1.914, 2.689)* |
| Per year in state with any medicaid case-mix | −0.11 (−0.267, 0.050) | −0.04 (−0.370, 0.297) | 0.12 (−0.251, 0.500) |
| Per year in states with any hospice CON | −0.45 (−0.616, −0.291)* | −0.79 (−1.091, −0.488)* | −1.16 (−1.547, −0.776)* |
| Case-mix admission severity† (increase of 1 standard deviation) | −0.58 (−0.820, −0.335)* | −0.43 (−0.799, −0.053)‡ | −0.13 (−0.571, 0.305) |
| Hospice providers in county (increase of 1 provider) | 0.08 (0.024, 0.134)§ | 1.06 (0.890, 1.227)* | 1.82 (1.512, 2.132)* |
a
Controlling for a nursing home’s occupancy rate; proportion of residents on Medicaid or Medicare, registered nurse, licensed practical nurse, and nursing assistant hours per patient day; presence of any special care unit; and at the county level, hospital and nursing home beds per 100 persons 65+ and physicians per 10,000 persons 65+.
†
Standardized.
*
P < 0.001.
‡
P < 0.05.
§
P < 0.01.