Hospital discharges to post-acute care (PAC) facilities have spiked. So have hospital readmissions from PACs, or skilled nursing facilities (SNFs). And that could be deadly, according to a recent study published in the Journal of Post-Acute and Long-Term Care Medicine (JAMDA).
"Patients who experienced readmission during their stay in a post-acute care facility were less likely to return to the community," says lead author Robert Burke, MD, academic hospitalist and health services researcher at the Denver VA Medical Center and an assistant professor at the University of Colorado (CU) School of Medicine in a university news release.
Researchers from the CU School of Medicine reviewed more than 3,200 hospitalizations followed by stays in PAC facilities. They found hospital readmissions were more common in patients that needed an invasive device, such as a feeding tube or urinary catheter, and advanced care, such as dialysis and oxygen therapy. Nearly half of the readmissions occurred within 14 days of being released from the hospital.
They also found readmitted patients were twice as likely as non-readmitted patients to die in the 30 days following hospital discharge and nearly four times as likely to die in the 100 days post-hospital discharge.
Understanding the causes of hospital readmission from PACs is key to improving the quality of patient care. The authors also found that payment systems matter and affect patient outcome including reimbursement models that penalize hospitals for readmissions.
"Under a prospective payment system, hospitals are incentivized to discharge these patients as early as possible, and in contrast to discharges home, hospitals are not currently penalized for readmissions from PAC facilities," the authors write. "PAC facilities may be substituting for prolonged hospital care in some cases."