The Contribution of Skilled Nursing Facilities to Hospitals’ Readmission Rate

Objective To examine the relative influence of hospital and skilled nursing facilities (SNFs) on 30‐day rehospitalization. Data Sources/Settings Elderly Medicare beneficiaries newly admitted to a SNF following hospitalization. Study Design We ranked hospitals and SNFs into quartiles based on previou...

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Bibliographic Details
Published in:Health services research Vol. 52; no. 2; pp. 656 - 675
Main Authors: Rahman, Momotazur, McHugh, John, Gozalo, Pedro L., Ackerly, Dana Clay, Mor, Vincent
Format: Journal Article
Language:English
Published: United States Health Research and Educational Trust 01.04.2017
Blackwell Publishing Ltd
John Wiley and Sons Inc
Subjects:
30‐day rehospitalization rate
Admission and discharge
Aged, 80 and over
Analysis
Beneficiaries
Discharge
Discharged
Female
Geriatrics
Hospital admission and discharge
Hospital care
hospital discharge
Hospitalization
Hospitals
Humans
Male
Medicare
Medicare - statistics & numerical data
Nurses
Nursing
Older people
Patient Discharge - statistics & numerical data
Patient Readmission - statistics & numerical data
Patients
Quality, Outcomes, and Innovation
Quartiles
Rates
Ratings & rankings
Readmission
Services
skilled nursing facilities
Skilled Nursing Facilities - statistics & numerical data
Studies
United States
United States
30-day rehospitalization rate
hospital discharge
skilled nursing facilities
ISSN:0017-9124, 1475-6773, 1475-6773
Online Access:Get full text
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Summary:Objective To examine the relative influence of hospital and skilled nursing facilities (SNFs) on 30‐day rehospitalization. Data Sources/Settings Elderly Medicare beneficiaries newly admitted to a SNF following hospitalization. Study Design We ranked hospitals and SNFs into quartiles based on previous years’ adjusted rehospitalization rates (ARRs) and examined how rehospitalizations from a given hospital vary depending upon the admitting SNF ARR quartile. We examined whether the availability of SNFs with low rehospitalization rates influenced hospitals’ SNF readmission rates and whether changes in a hospital's ARR over 3 years is associated with changes in the SNFs to which they discharge. Principal Findings Hospital readmission rates from SNFs varied 5 percentage points between patients discharged to SNFs in the lowest and the highest rehospitalization quartiles. Low rehospitalization rate hospitals sent a larger fraction of their patients to the lowest rehospitalization SNFs available in the area. A 10 percent increase in hospital's share of discharges to the lowest rehospitalization quartile SNFs is associated with a 1 percentage point reduction in hospital's ARR. Conclusions The SNF rehospitalization rate has greater influence on patients’ risk of rehospitalization than the discharging hospital. Identifying high‐performing SNFs may be a powerful strategy for hospitals to reduce rehospitalizations.
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The abstract for this paper was recognized as a winner at the 2015 AcademyHealth Annual Research Meeting and was invited to be published as part of the Health Services Research 2015 Best of ARM special section.
ISSN:0017-9124
1475-6773
1475-6773
DOI:10.1111/1475-6773.12507