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Discharging a affected person to a talented nursing facility or different sort of post-acute care facility after surgical procedure can add greater than $5,000 to care prices and is related to worse outcomes for older grownup sufferers.
In line with a examine printed within the Journal of the American Faculty of Surgeons, discharge to a post-acute care setting could also be a beneficial benchmark to assist hospitals consider how they’re serving older grownup surgical sufferers.
“The research shows that some discharges to a skilled nursing facility or other post-acute care facility postoperatively are preventable,” stated lead examine writer Sarah L. Remer, MD, a analysis fellow with the Division of Analysis and Optimum Affected person Care on the American Faculty of Surgeons (ACS) and a common surgical procedure resident at Loyola College Medical Heart in Maywood, Illinois. “By using this benchmark to guage efficiency in comparison with friends, hospitals can give attention to a number of the interventions that may forestall discharge to a post-acute care facility.
“Research shows that prehabilitation and similar perioperative mobility programs can prevent discharge to a non-home facility; investing time and effort in these kinds of programs to send patients home after surgery instead of sending them to a non-home facility may be worthwhile,” she stated.
The examine used knowledge from hospitals taking part within the ACS Nationwide Surgical High quality Enchancment Program (NSQIP), a knowledge 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 based mostly on the percentages ratio of discharging sufferers to post-acute care amenities.
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 circumstances.
84 hospitals (17%) have been low outliers, that means their price of discharge to post-acute care amenities was under the norm, 119 (24.1%) have been excessive outliers, and nearly 60% of hospitals carried out as anticipated. A clinically important variety of hospitals remained excessive and low outliers.
When the 25% of sufferers thought of 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.
The examine states that utilizing discharge to an acute-care facility as a benchmark might enable surgeons and hospital directors to guage their establishment’s efficiency and determine attainable 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.
“Research has demonstrated that there are interventions that can mitigate some unnecessary discharge to post-acute care facilities, such as screening patients at highest risk for poor outcomes, including discharge to post-acute care, and then utilizing those screenings to focus interventions on those high-risk patients, such as prehabilitation or more targeted physical therapy during the perioperative period,” Dr. Remer stated.
Dr. Remer added that hospitals can even 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.
Extra data:
Sarah L Remer et al, Discharge to Submit-Acute Care as a Benchmarking Metric for Aged Surgical Sufferers, Journal of the American Faculty of Surgeons (2025). DOI: 10.1097/XCS.0000000000001495
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American Faculty of Surgeons
Quotation:
A brand new metric for hospital high quality: What number of older adults go to a post-acute care facility after surgical procedure (2025, August 25)
retrieved 26 August 2025
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