AI Article Synopsis
- A study examined how the quality of skilled nursing facilities (SNFs) affects postoperative outcomes for patients undergoing hepatectomy, using Medicare data.
- Results showed that over 12% of patients required SNF admission and those discharged to SNFs were generally older and had higher rates of complications and readmissions compared to those discharged home.
- Despite differences in demographics and complications, the quality ratings of SNFs did not significantly impact the occurrence of new complications post-discharge; however, a significant number (30.1%) of patients discharged to SNFs were readmitted within 30 days.
Article Abstract
Background: An increasing number of patients require admission to a skilled nursing facility (SNF) following surgery. However, the impact of SNF quality on post-operative outcomes is unknown.
Methods: The Medicare Standard Analytic Files and Nursing Home Compare Dataset were used to define SNF utilization and determine the influence of SNF star quality ratings on outcomes following hepatectomy.
Results: Among 7256 Medicare beneficiaries, 918 (12.7%) required. Compared to patients discharged home, individuals discharged to SNF were older (median age: 75 [IQR 71-80] vs. 71 [IQR 68-76] years), and had a higher incidence of complications such as pulmonary failure, pneumonia, and acute renal failure during index hospitalization (all p < 0.05). Patients sent to a SNF were more likely to be readmitted within 30-days (30.1% vs. 13.4%, p < 0.001). The incidence of new complications within 30- and 90-days of discharge was similar regardless of star quality ratings (all p > 0.05). On multivariable analysis, Charlson comorbidity score ≥3 was the factor most strongly associated with 30-day readmission (OR 1.32-15.29, p = 0.016).
Conclusion: While post-discharge outcomes were similar across SNF quality ratings, roughly one in three Medicare patients discharged to a SNF were readmitted within 30-days.
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| http://dx.doi.org/10.1016/j.hpb.2019.05.012 | DOI Listing |
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