Selecting post-acute care settings after abdominal surgery: Are we getting it right?

Academic Article

Abstract

  • © 2017 Background: We investigated whether variation in post-acute care (PAC) services could be explained by surgeons discharging clinically similar patients to different PAC destinations, including home health (HH), skilled nursing facilities (SNF), and inpatient rehabilitation (IR). Methods: We studied patients having colectomy, pancreatectomy or hepatectomy in the 2008–2011 Nationwide Inpatient Sample. We used propensity matching to determine: 1. Proportion of patients discharged to SNF/IR who could be matched to clinically similar patients discharged with HH. 2. Potential cost savings from greater use of HH. Results: 30,843 patients were discharged with HH and 23,172 to SNF or IR. 14,163 (61%) SNF/IR patients could be matched to similar patients discharged with HH. Potential cost savings from increasing use of HH as an alternative to SNF/IR ranged from $2.5-$438 million annually. Conclusions: There is considerable potential for reducing variation in PAC use and costs by better understanding how surgeons make decisions about PAC placement.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Balentine CJ; Leverson G; Vanness DJ; Knight S; Turan J; Brown CJ; Chen H; Bhatia S
  • Start Page

  • 260
  • End Page

  • 266
  • Volume

  • 216
  • Issue

  • 2