Is higher volume of postacute care patients associated with a lower rehospitalization rate in skilled nursing facilities?

Yue Li, Xueya Cai, Jun Yin, Laurent G. Glance, Dana B. Mukamel

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

This study determined whether higher patient volume of skilled nursing facility (SNF) care was associated with a lower hospital transfer rate. Using the nursing home Minimum Data Set and the Online Survey, Certification, and Reporting file, we assembled a national cohort of Medicare SNF postacute care admissions between January and September of 2008. Multivariable analyses based on Cox proportional hazards models found that patients admitted to high-volume SNFs (annual number of admissions in the top tertile group) showed an approximately 15% reduced risk for 30-day rehospitalization and an approximately 25% reduced risk for 90-day rehospitalization, compared with patients admitted to low-volume SNFs (annual number of admissions in the bottom tertile group, or <45). Similar patterns of volume-outcome associations were found for hospital-based and freestanding facilities separately. The inverse volume-outcome association in postacute SNF care may reflect a "practice makes perfect" effect, a "selective referral" effect, or both.

Original languageEnglish (US)
Pages (from-to)103-118
Number of pages16
JournalMedical Care Research and Review
Volume69
Issue number1
DOIs
StatePublished - Feb 2012

Keywords

  • Minimum Data Set
  • postacute care
  • rehospitalization
  • skilled nursing facilities
  • volume-outcome association

ASJC Scopus subject areas

  • Health Policy

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