 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Lori Cooper, Masters of Public Administration, University of San Francisco, 1891 Andrews Dr., Concord, CA 94521, 925-689-7457, stonebrookh@aol.com, Tracie Buckland, Masters in Public Administration, University of San Francisco, 5106 Sims Mtn. Ct., Antioch, CA 94531, and Maurice Penner, PhD, College of Professional Studies, University of San Francisco, 8 Admiral Dr. # 128A, Emeryville, CA 94608.
Introduction. Lower access rates to nursing facilities (NFs) for Medicaid vs. self pay patients have been reported from analyses of existing data for these populations. We were unable to find published studies that observed admission decisions. Methods. We contacted a random sample of 97 California NFs certified for Medicaid. Each researcher stated she was calling for her father who needed custodial (nonskilled) care. Each facility was called twice, once with the fictional father as self pay and the other with Medicaid status. Results. Self pay callers were offered potential admission (contingent on assessment) 65% vs. 28% for Medicaid with an additional 16% vs. 5% invited to tour the facility, 13% vs. 30% offered a place on the waiting list (WL) and 6% vs. 37% other refusals respectively. Qualitative results regarding caller treatment by admission staff are discussed. Discussion. These results indicate significantly lower access for Medicaid patients needing custodial care and likely result from significantly lower reimbursement and NF limits on number of Medicaid patients. Some WL denied requests result in future admissions, based on data from a one facility WL update survey that found for 44 on its WL an average of 10 months, 57% were now in other NFs, 9% in board and care homes and 34% in home/caregiver domiciles. While access may improve over time, delay in receiving NF care can result in severe impacts on patients and caregivers.
Learning Objectives:
Keywords: Access to Health Care, Medicaid
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.