ArticleJournal of the American Medical Directors Association2017
Transitions From Skilled Nursing Facility to Home: The Relationship of Early Outpatient Care to Hospital Readmission.
Article in Journal of the American Medical Directors Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed.
- Preparedness for care transitions to home and acute care use of skilled nursing facility patients.BMC geriatrics · 2025Trial
- Life-Space of Older Adults after Discharge from Skilled Nursing Facilities.Journal of the American Medical Directors Association · 2024Trial
- LGBTQ+ inclusivity of the U.S. Department of Veterans Affairs' Home Based Primary Care services.Innovation in aging · 2026Article
- A Multi-Outcome Prognostic Model for Community-Dwelling Older Adults Admitted to Skilled Nursing Facilities for Post-Acute Care.Journal of the American Medical Directors Association · 2025Article
- Outcomes After Community Discharge From Skilled Nursing Facilities: The Role of Medicaid Home and Community-Based Services.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024Article
- 2024 Alzheimer's disease facts and figures.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- A Novel Risk Score to Predict Thirty-Day Readmissions after Acute Type A Aortic Dissections.The heart surgery forum · 2023Article
- Analysis of Functional Recovery in Older Adults Discharged to Skilled Nursing Facilities and Then Home.JAMA network open · 2022Article
- Progress Toward Digital Transformation in an Evolving Post-Acute Landscape.Innovation in aging · 2022Article
- Outcomes of a Nursing Home-to-Community Care Transition Program.Journal of the American Medical Directors Association · 2021Article
- Discharge processes in a skilled nursing facility affected by COVID-19.Journal of the American Geriatrics Society · 2021Article
- Where Skilled Nursing Facility Residents Get Acute Care: Is the Emergency Department the Medical Home?Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2021Article
- Complex Transitions from Skilled Nursing Facility to Home: Patient and Caregiver Perspectives.Journal of general internal medicine · 2021Article
- Receipt of Timely Primary Care Services Following Post-Acute Skilled Nursing Facility Care.Journal of the American Medical Directors Association · 2021Article
- Article
- The effectiveness of intermediate care including transitional care interventions on function, healthcare utilisation and costs: a scoping review.European geriatric medicine · 2020Article
- Skilled Nursing Facility Patients Discharged to Home Health Agency Services Spend More Days at Home.Journal of the American Geriatrics Society · 2020Article
- Adapting Project RED to Skilled Nursing Facilities.Clinical nursing research · 2020Article
- Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors.Journal of the American Medical Directors Association · 2020Article
- Home Health Care After Skilled Nursing Facility Discharge Following Heart Failure Hospitalization.Journal of the American Geriatrics Society · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundMany adults are discharged to skilled nursing facilities (SNFs) prior to returning home from the hospital. Patient characteristics and factors that can help to prevent postdischarge adverse outcomes are poorly understood.
objectiveTo identify whether early post-SNF discharge care reduces likelihood of 30-day hospital readmissions.
designSecondary data analysis using the Electronic Medical Record, Medicare, Medicaid and the Minimum Data Set. PARTICIPANTS/
settingOlder (age > 65 years), community-dwelling adults admitted to a safety net hospital in the Midwest for 3 or more nights and discharged home after an SNF stay (n = 1543). MEASUREMENTS: The primary outcome was hospital readmission within 30 days of SNF discharge. The primary independent variables were either a home health visit or an outpatient provider visit within a week of SNF discharge.
resultsOut of 8754 community-dwelling, hospitalized older adults, 3025 (34.6%) were discharged to an SNF, of whom 1543 (51.0%) returned home. Among the SNF to home group, a home health visit within a week of SNF discharge was associated with reduced hazard of 30-day hospital readmission [adjusted hazard ratio (aHR) 0.61, P < .001] but outpatient provider visits were not associated with reduced risk of hospital readmission (aHR = 0.67, P = .821).
conclusionFor patients discharged from an SNF to home, the finding that a home health visit within a week of discharge is associated with reduced hazard of 30-day hospital readmissions suggests a potential avenue for intervention.
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