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Post-acute care as substitute for inpatient care?


Some hospitals might be using post-acute care as a substitute for inpatient care, potentially leading to premature discharges and higher readmission rates, says a new study in Medical Care.

FierceHealthcare noted that “Researchers, led by Greg Sacks, M.D., analyzed data for more than 112,000 patients at 217 hospitals across 39 states derived from Medicare claims, American Hospital Association annual surveys and a national surgery registry. They found wide variation in the number of patents individual hospitals refer to inpatient facilities, ranging from 3 to 40 percent.”

“{T]hey found higher readmission rates and longer stays at facilities that are more likely to refer patients to inpatient facilities. Providers that most often referred patients to inpatient care had a likelihood of 24.1 percent for readmissions, compared to 21.2 percent for those that referred them least often. They found no such association for referrals to home healthcare.’

“Sacks and his team also determined teaching hospitals were more likely than non-teaching hospitals to refer patients to home healthcare, and that use of inpatient facilities correlated with shorter average length of stay.”

“The research team theorized the phenomenon may be the result of healthcare reimbursement policies that provide incentives for earlier discharges, and that further study is needed to determine the appropriateness of post-acute care.”

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