Discharge to home was associated with a 5.6% increase in hospital readmissions when compared to patients who went on to skilled nursing settings, according to a massive new data review published in JAMA Internal Medicine.
Though patients referred to home health services were more likely to be readmitted within 30 days, they were not significantly more likely to die or experience diminished functional outcomes. Medicare payments, however, were lower for those directed to home health services, according to researchers at the University of Pennsylvania and the University of Chicago.
“Understanding these trade-
offs is particularly important as new alternative payment models push patients toward lower-cost settings for care,” investigators reported.
The research team combed through Medicare claims data for more than 17 million patients treated between 2010 and 2016. The results are important for hospitals, which, like skilled nursing facilities, can lose up to 2% of their Medicare reimbursement for posting higher-than-average readmission rates.
“There has been such a big push to send patients home instead of to a skilled nursing facility to reduce costs that it was surprising to see how big of an impact that might be having on patient outcomes like readmissions,” said study co-author Rachel M. Werner, M.D., Ph.D.
From the April 1, 2019 Issue of McKnight's Long-Term Care News
