With discharge to post-acute care usually seen as an unanticipated and expensive surgical consequence, researchers are proposing that discharge to post-acute care might be used as a benchmarking metric in take care of older adults.
As a result of discharge to post-acute care can add greater than $5,000 to care prices and is related to worse outcomes for older sufferers, a examine printed within the Journal of the American School of Surgeons (JACS) suggests it could be a priceless benchmark to assist hospitals consider how they’re serving older grownup surgical sufferers.
“The analysis reveals that some discharges to a talented nursing facility or different post-acute care facility postoperatively are preventable,” stated lead examine creator Sarah L. Remer, M.D., a analysis fellow with the Division of Analysis and Optimum Affected person Care on the American School of Surgeons (ACS), in an announcement. “By using this benchmark to guage efficiency in comparison with friends, hospitals can give attention to among the interventions that may stop discharge to a post-acute care facility,” added Remer, who can also be a common surgical procedure resident at Loyola College Medical Middle in Maywood, Sick.
“Analysis reveals that prehabilitation and comparable perioperative mobility applications can stop discharge to a non-home facility; investing effort and time in these sorts of applications to ship sufferers residence after surgical procedure as an alternative of sending them to a non-home facility could also be worthwhile,” she stated.
The examine used knowledge from hospitals taking part within the ACS Nationwide Surgical High quality Enchancment Program (NSQIP), an information registry designed to enhance hospital-wide high quality throughout all surgical departments. The evaluation included 494 hospitals and 277,160 sufferers aged 65 years or older. The researchers used a mannequin to determine excessive and low outliers among the many studied hospitals primarily based on the percentages ratio of discharging sufferers to post-acute care services.
Key findings
• 11.2% (30,907) of older grownup sufferers have been discharged to a post-acute care facility, most of whom have been inpatient instances.
• 84 hospitals (17%) have been low outliers, that means their fee of discharge to post-acute care services was under the norm, 119 (24.1%) have been excessive outliers, and virtually 60% of hospitals carried out as anticipated. A clinically vital variety of hospitals remained excessive and low outliers.
• When the 25% of sufferers thought-about at highest threat for discharge to a post-acute care facility have been separated from the remainder of the examine inhabitants, 32.9% have been discharged to a post-acute care facility.
Introduced on the American Geriatrics Society 2025 annual assembly in Chicago, the examine states that utilizing discharge to an acute-care facility as a benchmark may enable surgeons and hospital directors to guage their establishment’s efficiency and determine doable areas for enchancment, drawing on beforehand printed proof suggesting that NSQIP benchmarking, together with rigorous knowledge evaluation and high quality enchancment initiatives, improves affected person care.
Remer added that hospitals may undertake high quality enchancment initiatives such because the ACS Geriatric Surgical procedure Verification program or comparable interventions to lower the variety of sufferers discharged to post-acute care.
