Patients and family members often prefer a patient to come home after hospitalization rather than spend time in a skilled nursing facility. Medicare will often cover the cost of at-home nursing visits and outpatient therapies, so it often works. This is also cheaper for Medicare, so it seems like a win-win situation for all. However, a new study finds that post hospital care in a skilled nursing facility may be more effective than bringing a patient straight home.
Why post hospital care can be better in a rehab center
The study, published in the Jama Open Network, was authored by the University of Pennsylvania’s Rachel Werner and Norma Coe and the University of Chicago’s Tamara Konetzka as well as other experts in the field.
They studied 17 million Medicare claims from January, 2010 through December 2016 to find patterns in Medicare spending. Their question was: “How are patient outcomes and Medicare spending affected by the decision to discharge patients to home with home health care vs to a skilled nursing facility for postacute care?”
The findings showed that it’s significantly cheaper for Medicare when patients go home, but that the 30 -day readmission rates were higher for home care patient. There was no difference in mortality.
What does this mean for patients?
These findings are somewhat alarming, because they point to the fact that for the patients themselves, receiving post hospital care in a rehab setting can be beneficial. However, there are significant savings to Medicare if patients skip the post hospital care in a facility, which may lead them to recommend home care more frequently than is actually good for the patient.
In previous studies, researchers found that post hospital care facilities sent patients back to hospital too quickly, but those findings potentially helped facilities re-calibrate and create more organized protocols about when to send a patient back. This new study shows that those efforts have paid off.
On the opposite side, while advocates often think its best or a patient to be in a home environment surrounded by family members, these well-meaning caregivers are often untrained and don’t have the skills to recognize when a patient needs immediate care and when he doesn’t. Due to pressure from Medicare to send patients out of hospitals more quickly, patients are often leaving the hospital stable, but still requiring intense care and treatment, which may be provided at home or at the doctor’s or therapist’s office. While facilities often offer training workshops for home caregivers, many family members who are also home health providers aren’t able to get the support and education they need to give over the most effective care.
There is not a lot of research that has been conducted about home health care after a hospitalization, but this can be the trigger to try to find out more information about what’s actually going on.
At the Alameda Center, we provide a warm and pleasant environment for patients to recover and expert post hospital care. Our professional team of doctors, nurses, therapists and other staff will look after your loved one and offer you the support and guidance you need to care for him best.