Nursing Facilities Can Reduce Avoidable Hospitalizations Without Increasing Mortality Risk For Residents

Area of Science:

• Healthcare quality improvement
• Geriatric care
• Public health policy

Background:

• Nursing facility residents often experience avoidable hospitalizations.
• Excessive hospitalizations increase healthcare costs and can negatively impact resident well-being.
• Previous studies focused on the initiative's success in reducing hospitalizations and costs.

Purpose of the Study:

• To investigate potential unintended consequences of the initiative on resident mortality.
• To assess the impact of the initiative on all-cause mortality rates in nursing facilities.

Main Methods:

• Tracked all-cause mortality rates for long-stay nursing facility residents from 2014-2016.
• Compared mortality rates in facilities participating in the initiative versus control groups.
• Analyzed changes in mortality rates relative to baseline and comparison facilities.

Main Results:

• No evidence of excess all-cause mortality was found among participating residents.
• Observed effects on mortality rates were small and not statistically significant.
• Mortality rate changes ranged from a 0.8% decrease to a 1.5% increase relative to comparison facilities.

Conclusions:

• The initiative to reduce hospitalizations in nursing facilities did not lead to increased mortality.
• Reducing unnecessary hospitalizations is achievable without adversely affecting resident survival rates.
• Findings support the safety of quality improvement initiatives aimed at decreasing nursing facility hospitalizations.