Hospitals or emergency departments readmit a large proportion of Medicare beneficiaries within 30 days of discharge from nursing homes, according to a new study published in the Journal of the American Geriatrics Society.
Twenty-two percent of 50,000 Medicare beneficiaries treated at skilled nursing facilities in North and South Carolina needed emergency care within 30 days of discharge, and 37.5 percent needed acute care within 90 days, according to lead author Mark Toles, Ph.D., an associate professor at the University of North Carolina at Chapel Hill School of Nursing.
Certain demographics were at higher risk for readmission than others. Men, older adults with cancer or respiratory diseases, and African-Americans were all more likely to require further acute care, according to the study. Patients who had a high number of prior hospitalizations and comorbid conditions, and received care at for-profit facilities, also correlated with a need for more acute care.
It is difficult to determine how many of these ER visits and readmissions nursing homes can prevent, according to Toles. Hospitals now emphasize the post-discharge transition to avoid readmission penalties and Toles said he hopes this data will encourage similar scrutiny for discharges from nursing homes.
"The role of nursing homes in communities has changed," Toles said in a statement. "These facilities are increasingly dedicated to transitioning older adults from the hospital back to their own homes. Short-term use of nursing facilities has grown tremendously over the past 10 years and we have to examine interventions that will improve that transition."
High readmissions are also problematic in inpatient rehabilitation facilities (IRFs); more than 10 percent of Medicare recipients are readmitted within 30 days of discharge from IRFs, a recent study found. For some conditions, such as debility, the readmission rate was as high as 18.8 percent, FierceHealthcare previously reported.