Observation Stay Use and Medicare Beneficiaries in Disadvantaged Neighborhoods

This month, an editorial entitled, “Unintended Consequences of Observation Stay Use May Disproportionately Burden Medicare Beneficiaries in Disadvantaged Neighborhoods,” was published (Volume 95, Issue 12, P2589-2591, December 01, 2020) in the Mayo Clinic Proceedings.  The editorial author’s findings include that “Medicare beneficiaries residing in the most disadvantaged neighborhoods (as defined by area deprivation index) are more likely to have an observation stay, have a repeated observation stay within 30-days, and experience long-term reobservation (which they define as multiple repeated observation stays within 30-days). They find that after adjusting for demographics, morbidity, and hospital characteristics, patients who live in the most disadvantaged areas (the top 15% by area deprivation index) had 13% higher odds of having a repeated observation stay within 30 days. Roughly 14% of the 16,400 observation stays with at least one 30-day reobservation also had multiple reobservations during that period. There was substantial geographic variation in these trends, and the level of neighborhood deprivation was positively associated with the odds of long-term reobservation.” You can read the full editorial here.