More than 20% of Medicare beneficiaries seek hospital care within a month of nursing home discharge, researchers find

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A large number of rehabilitation patients seek hospital care shortly after being discharged from a nursing facility, according to recently published research.

Investigators examined data from more than 50,000 Medicare beneficiaries in North and South Carolina. About 22% went to the hospital within 30 days of discharge from the nursing home, the researchers discovered. More than 37% sought acute care within three months of leaving the nursing facility.

“Nearly two million older adults use this benefit every year,” stated study author Mark Toles, Ph.D., RN, of the University of North Carolina-Chapel Hill School of Nursing. “Before this study, we didn't recognize the large number of older adults who require additional acute care after they're discharged from a nursing home.”

The researchers did not determine how many of these acute-care episodes might have been preventable. They did identify several risk factors for hospital admission following nursing home rehab, including the presence of cancer or respiratory disease. Men, African-Americans and patients in for-profit facilities also were more likely to go to the hospital, according to the findings.

Policymakers have proposed financial penalties for skilled nursing facilities with high rates of hospital readmissions, and Toles and his co-authors said their findings show the need for scrutiny in this area.

Researchers from Duke University, the Carolinas Center for Medical Excellence and the University of Pennsylvania School of nursing also were involved.

The findings appear in the Journal of the American Geriatrics Society.

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