Readmission Rates and Skilled Nursing Facility Utilization After Major Inpatient Surgery.

Area of Science:

• Healthcare Management
• Surgical Outcomes
• Health Services Research

Background:

• There is a growing interest in reducing postacute care utilization following major surgical procedures.
• Ensuring that reductions in postacute care do not negatively affect patient outcomes, such as readmission rates, is a key concern.

Purpose of the Study:

• To investigate the relationship between shifts in skilled nursing facility (SNF) use and subsequent changes in hospital readmission rates after major surgeries.
• To analyze trends in SNF utilization and readmission rates for specific surgical procedures over a defined period.

Main Methods:

• An observational study design was employed.
• Data were collected from fee-for-service Medicare beneficiaries who underwent coronary artery bypass grafting (CABG) or total hip replacement (THR) between 2008 and 2013.
• Risk-adjusted SNF use (0-2 days post-discharge) and risk-adjusted readmission rates (3-30 days post-discharge) were the primary exposure and outcome, respectively.

Main Results:

• Over the study period, SNF utilization increased for both CABG (16.4% to 19.0%) and THR (40.8% to 45.5%).
• Hospital readmission rates decreased significantly for CABG (14.7% to 12.7%) but remained stable for THR (4.9% to 4.8%).
• After adjusting for various factors, no statistically significant association was found between changes in SNF use and changes in readmission rates for either procedure.

Conclusions:

• The study found no significant association between changes in postacute care utilization, specifically SNF use, and changes in readmission rates following CABG and THR.
• These findings suggest that modifications in SNF utilization patterns may not directly influence readmission rates in the short term after these major surgeries.