Discharge from skilled nursing facility to home increases HF rehospitalization risk
Patients who were hospitalized for HF and were discharged from a skilled nursing facility to home had an increased risk for hospital readmission, according to a study published in the Journal of the American Medical Directors Association.
Himali Weerahandi, MD, assistant professor of medicine and population health at NYU Langone Health, and colleagues analyzed data from 67,585 patients (median age, 84 years; 61% women) who were Medicare Fee-for-Service beneficiaries. These patients were hospitalized for HF between July 2012 and June 2015, discharged to skilled nursing facilities and then discharged home.
The primary event of interest was the time from skilled nursing facility discharge to home with a composite outcome of interest of death or unplanned readmission within 30 days after discharge to home.
Of the patients in the study, 24.2% were readmitted to the hospital within 30 days after discharge from a skilled nursing facility.
Compared with days 3 to 30 after discharge, the HR of the composite outcome was significantly increased on days 0 to 2 in patients who stayed in a skilled nursing facility for 1 to 6 days (HR = 4.6; 95% CI, 4.23-5), 7 to 13 days (HR = 2.61; 95% CI, 2.45-2.78) and 14 to 30 days (HR = 1.7; 95% CI, 1.62-1.78).
“Transitions across the health care continuum must be enhanced in order to improve longitudinal care,” Weerahandi and colleagues wrote. “Further work should examine if formal discharge practices currently used in hospitals could be applied to the transition from [a skilled nursing facility] to home.” – by Darlene Dobkowski
Disclosures: Weerahandi reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.