RURAL ELDERLY PRESENT NEED FOR NURSING CONTINUITY

Over 25% of the elderly reside in rural areas. Elders residing in rura l areas have incomes that are approximately 20% less than their urban counterparts. One year of data on the 1,972 admissions of Medicare pat ients to a 150-bed rural hospital was studied to seek the commonalties marking four LOS categories of patients, including their 17+ day LOS outliers. Sixteen percent of all the Medicare admissions who tended to be older. have chronic illnesses and needed multiple services, fell i nto the 17+ day LOS group where reimbursement covered only one-third o f the actual cost of care provided. ICD-9 codes associated with the ca rdiac diagnostic category dominated, with 21.5% of those included in t his resource-intensive group. In preparing for capitated reimbursement , all efforts to develop systems to decrease ED visits and hospital st ays, while enhancing quality of life for the chronically ill, must be implemented.