Publication Type

Journal Article

Version

publishedVersion

Publication Date

5-2016

Abstract

BACKGROUND:In the health reform era, rehospitalization after discharge may result in financial penalties to hospitals. The effect of increased hospital-skilled nursing facility (SNF) linkage on readmission reduction after surgery has not been explored.METHODS:To determine whether enhanced hospital-SNF linkage, as measured by the proportion of surgical patients referred from a hospital to a particular SNF, would result in reduced 30-day readmission rates for surgical patients, we used national Medicare data (2011-2012) and evaluated patients who underwent 1 of 5 operative procedures (coronary artery bypass grafting [CABG], hip fracture repair, total hip arthroplasty, colectomy, or lumbar spine surgery). Initial evaluation was performed using regression modeling. Patient choice in SNF referral was adjusted for using instrumental variable (IV) analysis with distance between an individuals' home and the SNF as the IV.RESULTS:A strong negative correlation (P CONCLUSION:The benefits of increased hospital-SNF linkage seem to include meaningful reductions in hospital readmission after surgery. Overall, a 10% increase in the proportion of surgical referrals to a particular SNF is estimated to decrease readmissions by 4%. This may impact hospital-SNF networks participating in risk-based reimbursement models.

Discipline

Health and Medical Administration | Health Economics

Publication

Surgery

Volume

159

Issue

5

First Page

1

Last Page

15

ISSN

0039-6060

Identifier

10.1016/j.surg.2015.12.012

Publisher

Elsevier

Additional URL

https://doi.org/10.1016/j.surg.2015.12.012

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