دورية أكاديمية
أعرض في EDS

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.

التفاصيل البيبلوغرافية
العنوان: 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.
المؤلفون: Ryskina KL; Division of General Internal Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA. Electronic address: ryskina@pennmedicine.upenn.edu., Geng Z; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA., Raghavan S; US Department of Veterans Affairs Eastern Colorado Health Care System, Aurora, CO, USA., Waddell KJ; Division of General Internal Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA., Burke RE; Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, PA, USA; Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
المصدر: Journal of the American Medical Directors Association [J Am Med Dir Assoc] 2023 Dec; Vol. 24 (12), pp. 1881-1887. Date of Electronic Publication: 2023 Oct 11.
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 100893243 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1538-9375 (Electronic) Linking ISSN: 15258610 NLM ISO Abbreviation: J Am Med Dir Assoc Subsets: MEDLINE
أسماء مطبوعة: Publication: 2005- : [New York?] : Elsevier
Original Publication: Hagerstown, MD : Lippincott Williams & Wilkins, c2000-
مواضيع طبية MeSH: Patient Readmission* , Physicians*, Humans ; Aged ; United States ; Cohort Studies ; Skilled Nursing Facilities ; Medicare ; Retrospective Studies ; Hospitalization ; Patient Discharge ; Risk Factors
مستخلص: Objectives: How transitional care services are provided to patients receiving post-acute care in skilled nursing facilities (SNFs) is not well understood. We aimed to determine the association of timing of physician or advanced practice provider (APP) visit after SNF admission with rehospitalization risk in a national cohort of older adults.
Design: Retrospective cohort study.
Setting and Participants: 2,482,616 Medicare fee-for-service beneficiaries aged ≥66 years who entered an SNF for post-acute care following hospitalization.
Methods: We measured the relative risk of being rehospitalized within 14 days of SNF admission as a function of time to the first PAP visit, using time to follow-up as a time-dependent covariate, adjusted for patient demographics and clinical characteristics. We also evaluated whether findings extended across groups with different SNF prognosis on admission.
Results: Patients seen sooner after admission to an SNF (0-1 days) were less likely to be rehospitalized compared to patients seen later (≥2 days). The relative difference was similar across different risk groups.
Conclusions and Implications: Timely evaluation by a physician or APP after SNF admission may protect against rehospitalization. Investment in the workforce such as training programs, practice innovations, and equitable reimbursement for SNF visits after hospital discharge may mitigate labor shortages that were exacerbated by the COVID pandemic.
Competing Interests: Disclosure The author declares no relevant conflicts of interest or financial relationships.
(Copyright © 2023 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.)
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معلومات مُعتمدة: IK2 CX001907 United States CX CSRD VA; K08 AG052572 United States AG NIA NIH HHS; R01 AG066841 United States AG NIA NIH HHS; R01 AG071610 United States AG NIA NIH HHS
فهرسة مساهمة: Keywords: Nursing home; care quality; physician visit; post-acute care; rehospitalization
تواريخ الأحداث: Date Created: 20231014 Date Completed: 20231127 Latest Revision: 20240311
رمز التحديث: 20240311
مُعرف محوري في PubMed: PMC10840785
DOI: 10.1016/j.jamda.2023.09.004
PMID: 37837998
قاعدة البيانات: MEDLINE
الوصف
تدمد:1538-9375
DOI:10.1016/j.jamda.2023.09.004