Hospital patients discharged to homes or home healthcare settings are 38% more likely to return with a linked infection than those discharged to skilled nursing facilities, a University of Michigan study has found.
The researchers analyzed Medicare data to determine the risk of avoidable infection readmissions in nursing facility and home-care discharges and links to patient comorbidity.
The findings suggest that, while infections can spread at high rates in nursing facilities, SNFs are also adept at treating them, said lead author Geoffrey Hoffman, Ph.D., of the U-M School of Nursing.
“I was very surprised,” Hoffman said in a statement. “This is somewhat conflated with the conventional wisdom, which is that skilled nursing facilities are warehouses for infection transmission.
“The fact that patients discharged to skilled nursing had lower readmission rates for Clostridioides difficile infections than people discharged home is pretty amazing, given that those patients by definition are sicker and would more likely to be readmitted than those discharged home.”
Data was culled from Medicare records for more than 318,000 hospital discharges for patients 65 and older. Fifty percent of the patients were discharged to skilled nursing, 26% to home healthcare and 24% to home.
The most common infection found to be linked with hospital readmission was Clostridioides difficile (roughly 5% readmission), followed by urinary tract infections (2.4% readmission).
Despite nursing facilities’ relative success at keeping these readmissions in check, the numbers are still not ideal, said Hoffman. “Presumably [the patients have] been treated for the infection since the hospital has already billed Medicare,” Hoffman said. “Readmissions shouldn’t be zero, but they should be much closer to zero.”
The study was published Wednesday in the Journal of the American Geriatrics Society.