Related Experiment Video
Updated: Feb 7, 2026
Using Learning Outcome Measures to assess Doctoral Nursing Education
Published on: June 21, 2010
Readmission Rates and Skilled Nursing Facility Utilization After Major Inpatient Surgery
Lena M Chen1, Yubraj Acharya2, Edward C Norton3
1Division of General Medicine, University of Michigan, North Campus Research Complex, Ann Arbor, MI.
Background:
There is widespread interest in reducing use of postacute care (ie, care after hospital discharge) following major surgery, provided that such reductions do not worsen quality outcomes such as readmission rates.
Objectives:
To describe the association between changes in skilled nursing facility (SNF) use and changes in readmission rates after surgery.
Research Design:
This was a observational study.
Subjects:
Fee-for-service Medicare beneficiaries undergoing coronary artery bypass grafting (CABG) or total hip replacement (THR) from 2008 to 2013.
Measures:
Primary exposure was risk-adjusted SNF use initiated 0-2 days after hospital discharge, and the primary outcome was risk-adjusted readmission rates from 3 to 30 days after discharge.
Results:
Among 176,994 patients who underwent CABG at 804 hospitals and 233,955 patients who underwent THR at 1220 hospitals, hospital-level SNF utilization increased after CABG (16.4%-19.0%, P=0.001) and THR (40.8%-45.5%, P<0.001), from 2008 to 2013. Hospital readmission rates decreased for CABG (14.7%-12.7%, P<0.001) but did not change for THR (4.9%-4.8%, P=0.55), from 2008 to 2013. However, there was wide variation in hospital-level change in readmission rates. After adjusting for hospital characteristics and baseline readmission rates, there was no statistically significant association between change in SNF use and change in readmission rates (0.017 and 0.011 percentage point increase in SNF use for every one percentage point increase in readmission rates for CABG and THR respectively, P=0.58 and 0.32).
Conclusions:
Changes in use of postacute care after THR and CABG have not been associated with changes in readmission rates.
Related Concept Videos
01:19Major Organs of the Digestive System
Gastrointestinal tract:
01:27Major Hormones and Their Functions
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and...
01:28Major Losses in Pipes
Fluid flow can be classified as laminar or turbulent, primarily based on the Reynolds number. This dimensionless number reflects the relative influence of inertial to viscous...
03:09Measuring Reaction Rates
02:53Reaction Rate
The mathematical representation of the change in the concentration of reactants and products, over time, is the rate...
01:20Anatomy of the Brain: Major Regions
The cerebrum is the largest section of the brain and divides into left and right hemispheres, separated by a deep fissure. The cerebral outer layer of grey matter — the cerebral cortex — comprises elevations called gyri and shallow groves called sulci. The inner portion of white matter includes long nerve fibers known as axons, which connect...