A high percentage of Medicare patients who are discharged from nursing homes are returning to the hospital or emergency rooms (ER) within 30 days, according to a study from the University of North Carolina at Chapel Hill School of Nursing.
The study included more than 50,000 Medicare beneficiaries who were treated at skilled nursing facilities (SNFs) in North and South Carolina. Analyses conducted in collaboration with the Carolinas Center for Medical Excellence and investigators at Duke University revealed that approximately 22 percent of beneficiaries required emergency care within 30 days of discharge and 37.5 percent required acute care within 90 days.
Researchers also examined whether factors such as race and diagnosis increased the likelihood that older adults discharged from a nursing facility would return to the hospital. They found that men and African Americans were more likely to need additional acute care along with older adults with cancer or respiratory diseases. Other factors associated with a higher need for acute care included a high number of previous hospitalizations, comorbid conditions, and receiving care from a for-profit facility.
Researchers currently don’t know how many of these rehospitalizations and ER visits are preventable. Because the Affordable Care Act (ACA) penalizes hospitals for readmitting Medicare patients, there has been more focus on improving patients’ transition from the hospital to their home. Researchers hope this study will convince decision-makers to pay attention to transitions from nursing facilities as well.
The role of nursing homes in communities has changed, the study notes. These facilities are increasingly dedicated to transitioning older adults from the hospital back to their own homes. Short-term use of nursing facilities has grown tremendously over the past ten years and interventions that will improve that transition should be examined.
Source: The University of North Carolina at Chapel Hill, February 18, 2014
Accountable Care Strategies to Improve Hospital-SNF Care Transitions presents several case studies in reducing SNF-to-hospital readmissions. The hospital-to-SNF transition is one of the top three care transitions addressed by healthcare organizations, behind hospital-to-home and hospital-to-SNF, according to 2013 market data.