Transitions From Skilled Nursing Facility to Home: The Relationship of Early Outpatient Care to Hospital Readmission.
Jennifer L Carnahan, James E Slaven, Christopher M Callahan and 2 others
PMID 28647577WHAT IT FOUND
Older adults discharged home from a skilled nursing facility were less likely to be readmitted within 30 days if a home health visit occurred within a week.
Early outpatient clinic visits did not show the same overall benefit.
Key findings
01A home health visit within one week of discharge home from a skilled nursing facility was associated with lower 30-day hospital readmission.
02An outpatient provider visit within one week of skilled nursing facility discharge was not associated with reduced 30-day hospital readmission.
03Outpatient provider visits were associated with reduced readmission at weeks 2 and 3, but not at week 1 or 30 days.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a retrospective secondary analysis of records from one urban safety-net hospital in Indiana, so the results may not generalise to other populations or settings. It was observational, so it cannot prove that home health visits caused fewer readmissions; patients who received home health may have differed in ways the model did not capture. The study did not identify which parts of home health visits helped. Home health visits may include therapy, lab monitoring, medication reconciliation, caregiver collaboration, and environmental or social assessment, and their separate effects cannot be separated. The data were collected from January 1, 2007 to October 1, 2010, and post-acute care may have changed since then. The SNF-to-home analysis excluded patients who died in the SNF, did not enter the SNF directly from hospital, or stayed more than 106 days.
Declared interests
No authors have conflicts of interest to report.
The easy way to misread this
Do not conclude that arranging a home health visit will reduce a patient's risk of readmission. The study only found an association, and the home health visit includes several components whose separate effects cannot be separated.