ArticleHealth services research2026
Post-Hospital Access to Preferred and High-Quality Skilled Nursing Facilities for Patients With Opioid Use Disorder.
Article in Health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Post-Hospital Access to Preferred and High-Quality Skilled Nursing Facilities for Patients With Opioid Use Disorder.Health services research · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo examine whether Medicare beneficiaries with opioid use disorder (OUD) encounter limited access to hospitals' highest-volume (i.e., "preferred") or high-quality skilled nursing facilities (SNFs) compared to beneficiaries without OUD. STUDY SETTING AND
designWe estimated within-hospital disparities in access to preferred and high-quality SNFs by OUD status using linear probability models and discrete choice models (McFadden-style conditional logistic regression). We defined preferred status using shared hospital-SNF discharge volume and quality using CMS star ratings. In choice models, we matched patients with and without OUD 1:1 on discharging hospital and date, and applied inverse probability weighting and propensity score subclassification to address confounding. DATA SOURCES AND ANALYTIC SAMPLE: We used 2017-2021 Medicare inpatient claims to identify Medicare beneficiaries ages 18+ discharged to a SNF following hospitalization. PRINCIPAL
findingsIn the full sample (N = 6,490,593), patients with OUD were 2.5 and 3.6 percentage points (pp) less likely to enter preferred and high-quality SNFs, respectively. Among those discharged to preferred SNFs, patients with OUD were 2.0 pp less likely to enter high-quality preferred SNFs. In the matched subsample (n = 156,610), the marginal effect of preferred status on a person being discharged to their closest SNF was 1.1 pp lower for patients with OUD than those without OUD (p < 0.05), but with no significant disparity after inverse probability weighting. When the closest SNF's quality rating increased by 1 star, the probability of entry increased by 0.7 pp for people without OUD but decreased by 0.2 pp for people with OUD (difference = 0.9 pp, p < 0.001), a difference that persisted after weighting. CONCLUSIONS AND RELEVANCE: Publicly-reported star ratings had weaker associations with the SNF placements of Medicare beneficiaries with OUD compared to those without OUD, and preferred referral networks alone did not eliminate these gaps. Regulatory and reimbursement reforms that support SNFs in developing OUD-related care capacity and that promote equitable admissions deserve attention.
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