Year: 2017
Type: conference-abstract
Abstract: As hospital lengths of stay have decreased, more older adults have discharged to skilled nursing facilities (SNFs) prior to returning home. Patient characteristics and factors that prevent post-discharge adverse outcomes, such as hospital readmissions, are poorly understood. This study utilized a database comprised of data from one health system’s Electronic Medical Record, matched to Medicare, Medicaid and the Minimum Data Set. Among patients who transitioned from hospital to SNF to home, we used survival analysis to examine whether a home health visit or outpatient visit within one week of SNF discharge was associated with reduced hospital admission. Out of 8,754 community dwelling, hospitalized older adults with a hospital stay of 3 or more days, 4,577 were discharged home (52.3%; hospital to home group) and 3,025 (34.6%) were discharged to a SNF, of whom 1,543 (51.0%) returned home (SNF to home group). Patients discharged after SNF stay were older (median age 77.82 years v. 73.75, p<0.0001), had more comorbidities (median 6 v. 5, p<0.0001) and a longer hospital length of stay (median 7 v. 4 days, p<0.0001). After SNF discharge, a home health visit within a week was associated with reduced hazard of 30-day hospital readmission (adjusted hazard ratio (aHR) 0.61, p<0.0001) but outpatient physician visits were not (aHR=0.67, p=.8214). Patients discharged to a SNF prior to returning home are a high risk group. The finding that a home health visit within a week of discharge is associated with reduced hazard of 30-day hospital readmissions suggests a potential avenue for intervention.
Source: Innovation in Aging
Authors: J. Carnahan, J. Slaven, C.M. Callahan, W. Tu, A. Torke
Institution: Indiana University Indianapolis
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,977
OpenAlex ID: W2730783344