Nursing homes are widely used by Medicare beneficiaries who require rehabilitation after hospital stays. But according to a recent study led by a researcher at the University of North Carolina at Chapel Hill School of Nursing, a high percentage of Medicare patients who are discharged from nursing homes will return to the hospital or the emergency room within 30 days.
"Nearly two million older adults use this benefit every year," said assistant professor Mark Toles, the first author of the study. "Before this study, we didn't recognize the large number of older adults who require additional acute care after they're discharged from a nursing home."
The study included more than 50,000 Medicare beneficiaries who were treated at skilled nursing facilities in North and South Carolina. Analyses conducted in collaboration with the Carolinas Center for Medical Excellence and investigators at Duke University revealed that approximately 22 percent of beneficiaries required emergency care within 30 days of discharge and 37.5 percent required acute care within 90 days.
Toles and his colleagues also examined whether factors such as race and diagnosis increased the likelihood that older adults discharged from a nursing facility would return to the hospital. They found that men and African Americans were more likely to need additional acute care along with older adults with cancer or respiratory diseases. Other factors associated with a higher need for acute care included a high number of previous hospitalizations, comorbid conditions, and receiving care from a for-profit facility.