The contribution of skilled nursing facilities to hospitals' readmission rate
Objective To examine the relative influence of hospital and skilled nursing facilities (SNF s)
on 30‐day rehospitalization. Data Sources/Settings Elderly Medicare beneficiaries newly
admitted to a SNF following hospitalization. Study Design We ranked hospitals and SNF s
into quartiles based on previous years' adjusted rehospitalization rates (ARR s) and
examined how rehospitalizations from a given hospital vary depending upon the admitting
SNF ARR quartile. We examined whether the availability of SNF s with low rehospitalization …
on 30‐day rehospitalization. Data Sources/Settings Elderly Medicare beneficiaries newly
admitted to a SNF following hospitalization. Study Design We ranked hospitals and SNF s
into quartiles based on previous years' adjusted rehospitalization rates (ARR s) and
examined how rehospitalizations from a given hospital vary depending upon the admitting
SNF ARR quartile. We examined whether the availability of SNF s with low rehospitalization …
Objective
To examine the relative influence of hospital and skilled nursing facilities (SNFs) on 30‐day rehospitalization.
Data Sources/Settings
Elderly Medicare beneficiaries newly admitted to a SNF following hospitalization.
Study Design
We ranked hospitals and SNFs into quartiles based on previous years’ adjusted rehospitalization rates (ARRs) and examined how rehospitalizations from a given hospital vary depending upon the admitting SNF ARR quartile. We examined whether the availability of SNFs with low rehospitalization rates influenced hospitals’ SNF readmission rates and whether changes in a hospital's ARR over 3 years is associated with changes in the SNFs to which they discharge.
Principal Findings
Hospital readmission rates from SNFs varied 5 percentage points between patients discharged to SNFs in the lowest and the highest rehospitalization quartiles. Low rehospitalization rate hospitals sent a larger fraction of their patients to the lowest rehospitalization SNFs available in the area. A 10 percent increase in hospital's share of discharges to the lowest rehospitalization quartile SNFs is associated with a 1 percentage point reduction in hospital's ARR.
Conclusions
The SNF rehospitalization rate has greater influence on patients’ risk of rehospitalization than the discharging hospital. Identifying high‐performing SNFs may be a powerful strategy for hospitals to reduce rehospitalizations.
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