A reassessment of hospital product and productivity changes over time.

Were the changes found in the first year of the prospective payment system (PPS) one-time changes that attenuated as hospitals gained familiarity with the system? The results of this research show that, over time, discharges to home (self-care) continued to decrease, discharges to home health agencies continued to increase, but transfers and discharges to skilled nursing facilities or intermediate care facilities accounted for an increasing share of total discharges. After a dramatic decrease in the first year, the use of laboratory tests, diagnostic tests, and X-rays returned, over time, almost to pre-PPS levels.