Effect of hospital-SNF referral linkages on rehospitalization.
Health Serv Res
; 48(6 Pt 1): 1898-919, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-24134773
ABSTRACT
OBJECTIVE:
To determine whether the rate of rehospitalization is lower among patients discharged to skilled nursing facilities (SNFs) with which a hospital has a strong linkage. DATA SOURCES/COLLECTION We used national Medicare enrollment, claims, and the Minimum Data Set to examine 2.8 million newly discharged patients to 15,063 SNFs from 2,477 general hospitals between 2004 and 2006. STUDYDESIGN:
We examined the relationship between the proportion of discharges from a hospital and alternative SNFs on the rehospitalization of patients treated by that hospital-SNF pair using an instrumental variable approach. We used distances to alternative SNFs from residence of the patients of the originating hospital as the instrument. PRINCIPALFINDINGS:
Our estimates suggest that if the proportion of a hospital's discharges to an SNF was to increase by 10 percentage points, the likelihood of patients treated by that hospital-SNF pair to be rehospitalized within 30 days would decline by 1.2 percentage points, largely driven by fewer rehospitalizations within a week of hospital discharge.CONCLUSIONS:
Stronger hospital-SNF linkages, independent of hospital ownership, were found to reduce rehospitalization rates. As hospitals are held accountable for patients' outcomes postdischarge under the Affordable Care Act, hospitals may steer their patients preferentially to fewer SNFs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Readmisión del Paciente
/
Derivación y Consulta
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Instituciones de Cuidados Especializados de Enfermería
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Relaciones Interinstitucionales
Aspecto:
Equity_inequality
Límite:
Aged
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Aged80
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Female
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Humans
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Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Health Serv Res
Año:
2013
Tipo del documento:
Article