Post-acute care tradeoff: shorter stays for higher readmission

With no real guidelines for determining postacute care for patients, it’s up to hospitals to make up their own policies and decisions. A new national study published in The Journal of Medical Care found the number of postacute patients sent to inpatient facilities can vary from 3% to 40% depending on the hospital. The variation is even greater for home healthcare, with hospitals prescribing it for anywhere between 3% to 58% of their patients.

“These findings suggest that some hospitals may be using postacute care as a substitute for inpatient care,” said lead study investigator Dr. Greg Sacks in a statement. “This might lead to patients being discharged from the hospital prematurely, which then results in higher readmission rates.” 

The study found that sending more postacute care patients to inpatient facilities resulted in an increase of 30-day readmissions (24.1%) compared to hospitals that referred less often (21.2%).

 “Our findings suggest that there is an urgent need to study the appropriate use of postacute care to develop guidelines to assist postoperative discharge planning,” researchers wrote. “The new evidence and guidelines based on that evidence would help ensure that patients receive the post-discharge care they need, while avoiding additional care they do not need.”

Fortunately, researchers found no link between the use of postacute care and rates of complications and mortality. The study also found that a larger number of postacute care referrals dropped the hospitals’ average length of stay.