Research conducted by UCLA investigators suggests that hospitals that tend to refer patients to post-acute care also tend to have shorter lengths of stays and higher readmission rates.
Lead investigator Greg Sacks, MD—a general surgery resident at UCLA and a Robert Wood Johnson/Veterans Affairs Clinical Scholar—and the rest of his research team analyzed data for 112,620 patients treated at 217 hospitals in 39 states. They drew information from a national surgery registry and Medicare claims, as well as from American Hospital Association annual surveys from 2005 through 2008. They calculated the correlation between post-acute care usage rates and hospital quality measures such as mortality rates, complications, readmissions and lengths of stay, explains a media release from University of California, Los Angeles Health Sciences.
The study, published recently in the journal Medical Care, found that some hospitals refer fewer than 3% of their patients to inpatient facilities while others refer up to 40%. Similarly, some hospitals prescribe home health care for just 3% of patients; others refer as many as 58% of patients, per the release.
In addition, hospitals that referred patients to inpatient facilities most often were likelier to readmit patients within 30 days (24.1%) versus those who referred patients to inpatient facilities least often (21.2%). The study did not find a similar correlation between referrals to home health care and hospital readmission, the release states.
The study also found that: Teaching hospitals referred patients to home health care 21.4% of the time, versus 18.0% for non-teaching hospitals; and that hospitals with the shortest average length of stay used inpatient facilities more frequently (24% versus 19.5%).
“These findings suggest that some hospitals may be using post-acute care as a substitute for inpatient care,” Sacks says in the release. “This might lead to patients being discharged from the hospital prematurely, which then results in higher readmission rates.”
Sacks and his colleagues suggest in their study that healthcare payment policies that create financial incentives for hospitals to discharge patients prematurely could be driving hospitals’ post-acute care decisions.
They add that their findings suggest the need to study the use of post-acute care to develop guidelines to assist postoperative discharge planning, per the release.
“The new evidence and guidelines based on that evidence would help ensure that patients receive the post-discharge care they need, while avoiding additional care they do not need,” Sacks states, according to the release.
[Source(s): University of California, Los Angeles Health Sciences; Newswise]
