Researchers examined data of all observation and inpatient visits at the medical centers, more than 31,000, between Jan. 1, 2012 and Feb. 28, 2013.
They found a net transition of 14.9 percent from inpatient status to observation status for all encounters.
Here are six more statistics on the clinical impact of the two-midnight rule from the study.
• Looking solely at Medicaid encounters, researchers found a net transition of 7.4 percent from inpatient status to observation status.
• For adult general medicine, the study showed a 2.2 percent decrease in inpatient status for all insurance types, but there was a 2.4 percent increase in inpatient status for Medicare patients.
• Time of admission may affect patient status, as observation encounters admitted before 8 a.m. lasted two midnights 13.6 percent of the time, and observation encounters admitted after 4 p.m. lasted two midnights 31.2 percent of the time.
Researchers suggest “CMS should define observation care per its original intent: as a means to determine if a patient can safely return home after a short period of additional care. Patients whose conditions necessitate an intensity and level of service beyond this narrow scope should be classified as full inpatients irrespective of [length of stay], whether that LOS is <2 midnights or ≥2 midnights,” according to the report.
More Articles on the Two-Midnight Rule:
CMS Delays Two-Midnight Rule
Hospital Leaders to Congress: Two-Midnight Rule is Arbitrary, Confusing
Hospitals Move Forward With Two-Midnight Rule Challenge
