Trends in Hospital Admissions From Veterans Administration Nursing Homes
Year: 2018
Type: article
Study design: Observational Study
Abstract: Among patients in nursing homes owned and operated by the Veterans’ Administration, called Community Living Centers (CLCs), hospitalizations home can cause distress and disruption of continuity of care for patients and impose costs on the health system. In this study, we described trends in hospitalization rates among Veterans in CLCs. Hospitalization rate is defined as the transfers from VHA Community Living Center (CLC) to hospital per patient-day. We excluded planned hospitalizations, which we defined using the Yale re-hospitalization algorithm used by the Centers for Medicare and Medicaid Services in assigning financial penalties for rehospitalization from post-acute care. We studied all Veterans ever admitted to any of the 133 CLCs from 2007 to 2016. Overall, hospitalizations in CLCs decreased by 13%, from 1.35 per resident-year in 2007 (median 1.16, IQR 0.77 – 1.70) to 1.18 in 2016 (median 1.06, IQR .59 – 1.59). The average rate of decrease was -0.02 per year, or 1.7%. In spite of high staff-to-resident ratios compared to community nursing homes, the hospitalization rate among CLCs is higher than similar non-VA, community nursing homes, with a mean hospital admission rate of 1.08 per resident year in the period from 2011–2015 (median 0.97, IQR .67 – 1.4). The VA issued directives in 2008 and 2012 to shift the use of CLCs away from long-stay care and toward short-stay and post-acute care. Our findings suggest that in spite of increasing patient acuity that would accompany these changes, rates of hospital admissions are decreasing overall.
Source: Innovation in Aging
Authors: P Cornell, R Makineni, V Mor
Institution: Brown University
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,977
OpenAlex ID: W2899623724