Hospitals appear to have very different philosophies on where to put patients for post-acute care.
According to a new study by a team of UCLA researchers that examined 112,620 patients at 217 hospitals, some hospitals refer patients to in-patient facilities far more than others.
While the average hospital referred 20.7 percent of patients to such facilities after acute care, the range spanned from a low of 2.7 percent to a high of 39.7 percent.
Similarly, some hospitals refer only about 3 percent of patients to home care, while others refer 40 percent to home care.
The study did not find compelling evidence to suggest that certain patterns were associated with higher mortality rates.
But it did find that hospitals that refer a higher proportion of patients to in-patient facilities tend to have higher 30-day readmission rates. And the patients typically stay for shorter periods of time in the hospital.
That suggests to researchers that hospitals may be referring those recovering from surgeries or illnesses to in-patient facilities too soon.
“These findings suggest that some hospitals may be using post-acute care as a substitute for inpatient care,” said Dr. Greg Sacks, the study’s lead investigator, in a university news release. “This might lead to patients being discharged from the hospital prematurely, which then results in higher readmission rates.”
The study further suggests that health care payment formulas may be driving hospitals’ decisions to discharge patients earlier than they should.
But the study does not propose any specific solutions, instead saying the issue needs to be studied further in an effort to strike a balance between ensuring patients receive adequate care and avoiding unnecessary care.
“Our findings suggest that there is an urgent need to study the appropriate use of post-acute care to develop guidelines to assist postoperative discharge planning,” it said.
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