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Inpatient stays: OIG reports on quality of care

Credentialing Resource Center Connection, June 23, 2005

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According to a June 2005 inspection report from the Office of Inspector General (OIG), 20% of the consecutive inpatient stay sequences it studied involved poor-quality care and/or unnecessary fragmentation of care.

The report, "Consecutive Medicare Inpatient Stays," looked at patients with three or more stays at an inpatient facility where the admission date for each stay was within one day of the discharge date for the previous stay. The study focused specifically on rehabilitation units, psychiatric units, and skilled nursing units.

The OIG reports there were 63,345 sequences of consecutive inpatient stays (210,555 individual stays) involving these facilities in the 2002 fiscal year, accounting for $1.9 billion in Medicare payments.

The report states that while the majority of consecutive inpatient stays reviewed by the OIG were medically necessary and appropriate, 20% were the result of

• failure to treat patients in a timely manner
• inadequate monitoring and treatment of patients
• inadequate care planning.

Go to http://oig.hhs.gov/oei/reports/oei-03-01-00430.pdf for the full report.

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