Post-Acute Care Outcomes and Functional Status Changes of Adults with New Cancer Discharged to Skilled Nursing Facilities.
Sarguni Singh, Elizabeth Molina, Elisabeth Meyer and 2 others
PMID 35337793WHAT IT FOUND
Survival was best among older adults with newly diagnosed advanced cancer discharged to a skilled nursing facility when they received cancer treatment and no hospice.
Among those with complete ADL data, mean improvement was 1.5 to 3.1 points on a 28-point scale.
Key findings
01Patients who received cancer treatment but not hospice had the best survival, while patients who received hospice only had the worst survival.
02Among the 2,758 patients with both admission and discharge ADL assessments, mean ADL scores changed from 17.1 to 15.1 on a 0-28 scale, and mean ADL improvement was 1.5 to 3.1.
03Greater improvement in ADL self-performance scores between admission and discharge was associated with improved survival, although more than half of patients lacked both scores.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for RNs
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What it does not show
The study is observational and administrative, so it cannot show that cancer treatment, hospice status, or ADL improvement caused survival differences. Only 2,758 patients had both admission and discharge ADL scores, and more than half could not be included in ADL-adjusted models. The sample was restricted to Medicare fee-for-service beneficiaries aged 66 and older with newly diagnosed stage II-IV colorectal, pancreatic, bladder, or lung cancer and no prior cancer treatment, so results may not apply to younger patients, other cancers, Medicare Advantage, or previously treated cancer. Patients were grouped by treatment and hospice receipt rather than cancer type and stage, and facility characteristics such as staffing and payment source were not assessed. The data were from 2011 to 2013 and do not reflect current use of newer targeted therapies or immunotherapy.
Declared interests
The supplied article text does not include a conflict-of-interest or funding statement. The publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that skilled nursing facility rehabilitation or cancer treatment causes longer survival. The study is observational, patients were grouped by treatment and hospice receipt, and ADL data were missing for more than half of patients.