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 language | English (US) |
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Pages (from-to) | 103-118 |
Number of pages | 16 |
Journal | Medical Care Research and Review |
Volume | 69 |
Issue number | 1 |
DOIs | |
State | Published - Feb 2012 |
Keywords
- Minimum Data Set
- postacute care
- rehospitalization
- skilled nursing facilities
- volume-outcome association
ASJC Scopus subject areas
- Health Policy