Association between Timing of Clinical Evaluation by a Physician or Advanced Practitioner and Risk of Rehospitalization in Older Adults Admitted to a Skilled Nursing Facility Following Hospitalization: A Cohort Study.
Kira L Ryskina, Zhi Geng, Sridharan Raghavan and 2 others
PMID 37837998WHAT IT FOUND
In skilled nursing facilities, a later first visit by a physician or advanced practitioner was associated with higher 14-day rehospitalization risk.
Each day later was associated with 3% to 35% higher risk.
Key findings
01In the cohort, 246,669 (9.9%) were rehospitalized within 14 days.
02A later first visit by a physician or advanced practitioner was associated with higher 14-day rehospitalization: each additional day was associated with 3% to 35% higher hazard.
03The validated SNF prognosis score did not differ between patients seen earlier or later in their stay.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study did not randomize visit timing, so it cannot show that earlier visits caused lower rehospitalization. Patients who were seen later may have differed in ways not measured, including how sick they were on arrival to the facility. Only billed visits were captured, and same-day visits by multiple providers may not be recorded. Medicare Advantage beneficiaries were excluded. The data are from 2012 to 2014 and may not reflect current practice. The prognosis score was designed for the whole SNF stay, not only the first 14 days.
Declared interests
The authors declared no conflicts of interest. The article lists NIH and U.S. government research support.
The easy way to misread this
Do not read this as proof that scheduling a physician or advanced practitioner visit earlier will prevent rehospitalization. It is an observational cohort, and patients who were seen later may have differed in ways not measured.