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Health Serv Res. 1986 October; 21(4): 477–498.
PMCID: PMC1068967

Hospital swing-bed care in the United States.


As a result of federal legislation implemented in 1982, hospital beds that are used to provide both long-term care and acute care are now proliferating rapidly throughout the country. Termed swing beds, such beds are currently restricted to rural areas. However, due largely to the impacts of Medicare DRG reimbursement, pressure is mounting to expand the swing-bed approach to urban settings. Swing beds appear to fill a significant gap between the relatively intense medical needs of post-acute care patients (now discharged earlier) and the capacity of our current nursing home delivery system to meet such needs. The evolution of swing beds is marked by an unusual blend of experimentation, scientific investigation, and public policy response to community and personal health care needs. This article summarizes that evolution, highlighting research findings and key policy developments. It concludes with the current status of the national swing-bed program and issues pertinent to future directions.

Full text

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Aland KM, Walter BA. Hospitals in Utah reduce costs, improve use of facilities. Hospitals. 1978 Mar 16;52(6):85–87. [PubMed]
  • Walter BA, West JD, Elggren MD. Small hospitals find swing beds profitable. Forum (Wash) 1980 Jun;4(2):16–17. [PubMed]
  • Burton RD. Swing-bed concept in Utah . . . a decade of experience 1982. J Patient Acc Manage. 1982 Apr-May;:10–16. [PubMed]
  • Hanus J. Two rural hospitals' projects apply swing bed concept successfully. Hosp Prog. 1980 May;61(5):63–77. [PubMed]
  • Leaver W. The swing bed concept. Mich Hosp. 1980 Feb;16(2):20–22. [PubMed]
  • Supplitt JT. Swing beds: new diversification opportunity for small and rural hospitals. Hospitals. 1982 Nov 16;56(22):67–72. [PubMed]
  • Pennell F. Reimbursement: "carve-out' method benefits swing-bed hospitals. Hospitals. 1982 Nov 16;56(22):79–84. [PubMed]
  • Jessee WF. Quality assurance: evaluating services of small, swing-bed hospitals. Hospitals. 1982 Nov 16;56(22):74–77. [PubMed]
  • Shaughnessy PW, Schlenker RE. Planning: implementing new swing-bed programs. Hospitals. 1982 Nov 16;56(22):86–90. [PubMed]
  • Jones L. Survey shows growing hospital involvement in health promotion activities. Hospitals. 1982 Jun 1;56(11):88–90. [PubMed]
  • Richardson H, Kovner AR. Implementing swing-bed services in small rural hospitals. J Rural Health. 1986 Jan;2(1):46–60. [PubMed]
  • Shaughnessy PW, Tynan EA. The use of swing beds in rural hospitals. Inquiry. 1985 Fall;22(3):303–315. [PubMed]
  • Shaughnessy PW, Lutz E. Nurse/physician reactions to 'swing beds'. Hosp Med Staff. 1979 Mar;8(3):10–18. [PubMed]
  • Shaughnessy PW, Breed LD, Landes DP. Assessing the quality of care provided in rural swing bed hospitals. QRB Qual Rev Bull. 1982 May;8(5):12–20. [PubMed]
  • Shaughnessy PW, Kramer AM, Schlenker RE, Polesovsky MB. Nursing home case-mix differences between Medicare and non-Medicare and between hospital-based and freestanding patients. Inquiry. 1985 Summer;22(2):162–177. [PubMed]
  • Shannon K. Swing-bed program's success spurs proposals to expand eligibility. Hospitals. 1985 Mar 1;59(5):78–78. [PubMed]
  • Smits HL. Incentives in case-mix measures for long-term care. Health Care Financ Rev. 1984 Winter;6(2):53–59. [PubMed]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust