Increased Hospital and Post-Acute Care Coordination Improves Outcomes

According to a new study in JAMDA, better coordination between hospitals and post-acute care facilities could reduce patient readmission to hospitals as well as mortality rates.

The causes of hospital readmission from post-acute care facilities are critical areas of study in order to improve the quality of patient care and to prepare for reimbursement models that penalize hospitals for patient readmissions.

Researchers from the University of Colorado School of Medicine (Aurora, CO) reviewed more than 3200 hospitalizations followed by stays in post-acute care facilities and found specific risk factors that may have contributed to readmission to the hospital. Nearly half of the readmissions occurred within 14 days of the patient’s discharge from the hospital. The study identified the need for an invasive device, such as a feeding tube or urinary catheter, and the need for advanced care, such as dialysis and oxygen therapy, as factors more common in readmitted patents.

“Patients who experienced readmission during their stay in a post-acute care facility were less likely to return to the community,” said lead author Robert Burke, MD (Denver VA Medical Center, Denver, CO, and University of Colorado School of Medicine). Readmitted patients were also twice as likely to die in the 30 days after hospital discharge, and nearly four times as likely to die in the 100 days after hospital discharge, as non-readmitted patients.

In addition, the authors also found that payment systems affected patient outcomes. Because hospitals are incentivized to discharge patients as early as possible under prospective payment systems, the authors wrote, “PAC facilities may be substituting for prolonged hospital care in some cases.”

The authors suggest that hospitals and post-acute care facilities focus on implementing processes to improve transitional care. —Amanda Del Signore