Ventilator-associated pneumonia among elderly Medicare beneficiaries in long-term care hospitals.

Ventilator-associated pneumonia (VAP) is a complication of ventilator care that produces excess, avoidable resource use and treatment costs. Control of VAP is an important aspect of quality of care improvement for long-term care hospitals (LTCHs) since they provide post-acute ventilator care for many Medicare beneficiaries. Data for Medicare patients discharged from LTCHs during CY 2004 who received continuous mechanical ventilation are examined (N=13,759).

Cranial surgery among Medicare beneficiaries.

Background: This article examines the incidence of inpatient cranial surgery among Medicare beneficiaries. Many of these surgeries are trauma related or reflect chronic disabilities. The costs of care and the mortality rates are high for these patients.

Provider Opt-Out Under Medicare Private Contracting.

The 1997 Balanced Budget Act (BBA) permits private contracting for care between Medicare beneficiaries and providers who have opted out of Medicare. This article examines the number and characteristics of providers who have opted-out, their role in the provision of Part B services, and their impact on beneficiary access from 1998 to 2002. Opt-out providers differ from providers remaining in Medicare with respect to specialty, practice characteristics, and Medicare Program activity.