After hospital discharge to a skilled nursing facility, better performance on various measures of quality of care was not consistently associated with a lower risk of hospital readmission or death at 30 days among fee-for-service Medicare beneficiaries, according to recently published study results.
Researchers examined the association between skilled nursing facility (SNF) performance on publicly available metrics and the risk of readmission of death 30 days after discharge to a SNF among fee-for-service Medicare beneficiaries discharged after an acute care hospitalization between September 2009 and August 2010. Patients’ case mix, SNF facility factors and the discharging hospital were controlled for in adjusted analysis.
Study results showed 1,530,824 patients were discharged, with 321,709 readmitted within 30 days and 72,472 dying within 30 days. The researchers found that SNFs with better staffing ratings had a lower unadjusted risk of readmission or death, and SNFs ranked lowest had a 25.5% 30-day risk of readmission or death vs. 19.8% among SNFs ranked highest. Similarly, a lower risk of readmission or death was found among SNFs with better facility inspection ratings. These associations were attenuated when adjusted for patient factors, SNF facility factors and the discharging hospital, and researchers observed small differences in the adjusted risk of readmission or death according to SNF facility inspection ratings. However, study results showed no other measures predicted clinically meaningful differences in the adjusted risk of readmission or death.
For more information:
Neuman MD. JAMA. 2014;doi:10.1001/jama.2014.13513.
Disclosure: See the full study for all authors’ relevant financial disclosures.
