Trends in Post-Acute Care Utilization During the COVID-19 Pandemic.
Rachel M Werner, Eric Bressman
PMID 34555340WHAT IT FOUND
Among older hospital discharges, skilled nursing facility use fell from 19% to 14% by October 2020, while home self-care rose slightly.
Post-acute spending shifted away from skilled nursing facilities.
Key findings
01The share of older hospital discharges going home for self-care rose from an average of 52% in 2019 to 54% in October 2020.
02Skilled nursing facility use declined from 19% of discharges in 2019 to 14% in October 2020, and the October 2020 admission rate was 51% of the prepandemic rate.
03Spending on skilled nursing facilities fell from 39% to 31% of post-acute care spending, while inpatient rehabilitation rose from 36% to 42%.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study measured utilization and spending, not patient outcomes. The analysis excluded about 2% of discharges that went to long-term acute care hospitals, hospice, or other institutional settings. The cohort was commercially insured and included Medicare Advantage beneficiaries. The trends occurred during the pandemic and may reflect pre-existing movement away from skilled nursing facilities and changes in hospitalizations, not a single cause.
Declared interests
The supplied article metadata says the work was supported by an NIH extramural grant. No author conflicts of interest are stated in the supplied text.
The easy way to misread this
Do not read the decline in skilled nursing facility use as evidence that home-based post-acute care is safe or sufficient. The study reports utilization and spending, not patient outcomes.