Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study.
Himali Weerahandi, Li Li, Haikun Bao and 6 others
PMID 30954133WHAT IT FOUND
24.2% of heart failure hospitalizations discharged from a skilled nursing facility to home were readmitted within 30 days.
The rate of unplanned readmission or death was about 2-4 times higher on days 0-2 after SNF discharge than on days 3-30.
Key findings
01Of 67,585 heart failure hospitalizations discharged from a skilled nursing facility to home, 16,333 (24.2%) were readmitted within 30 days of SNF discharge.
02The rate of unplanned readmission or death was about 2-4 times higher on days 0-2 after SNF discharge than on days 3-30, regardless of SNF length of stay.
03The ratio of the days 0-2 rate to the days 3-30 rate decreased as SNF length of stay increased.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was observational, so it could not prove that SNF discharge, length of stay, or care transitions caused readmission or death. It used administrative Medicare claims, which may misclassify admission and discharge dates and cannot account for disease severity, frailty, cognition, or function. It did not adjust for the quality of discharge care at the SNF or post-discharge factors. It only included patients who survived to SNF discharge, so people who died before discharge are not represented. It excluded patients with SNF stays longer than 30 days and admissions initially from SNF, so it does not describe all post-acute care patients.
Declared interests
The authors declared no conflicts of interest. The paper is listed as supported by NIH and U.S. government funds.
The easy way to misread this
Do not conclude that longer SNF stays or specific discharge practices prevent readmission. This observational study showed risk patterns, not tested interventions, and it could not account for disease severity, function, or quality of discharge care.