Observational studyJournal of the American Geriatrics Society2019
Transitional Care Outcomes in Veterans Receiving Post-Acute Care in a Skilled Nursing Facility.
Observational study in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 15 citations in OpenAlex.
- Prediction of rehospitalization and mortality risks for skilled nursing facilities using a dimension reduction approach.BMC geriatrics · 2023Article
- Study protocol: Type III hybrid effectiveness-implementation study implementing Age-Friendly evidence-based practices in the VA to improve outcomes in older adults.Implementation science communications · 2023Article
- Telehealth Palliative Care in Nursing Homes: A Scoping Review.Journal of the American Medical Directors Association · 2023Article
- How Context Influences Hospital Readmissions from Skilled Nursing Facilities: A Rapid Ethnographic Study.Journal of the American Medical Directors Association · 2021Article
- Variability in Transitional Care Outcomes Across Hospitals Discharging Veterans to Skilled Nursing Facilities.Medical care · 2020Observational
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAs the veteran population ages, more veterans are receiving post-acute care in skilled nursing facilities (SNFs). However, the outcomes of these transitions across Veterans Affairs (VA) and non-VA settings are unclear.
objectiveTo measure adverse outcomes in veterans transitioning from hospital to SNF in VA and non-VA hospitals and SNFs.
designRetrospective observational study using the 2012 to 2014 Residential History File, which concatenates VA, Medicare, and Medicaid data into longitudinal episodes of care for veterans.
settingVA and non-VA hospitals and SNFs in four categories: non-VA SNFs, VA-contracted SNFs, VA Community Living Centers (CLCs), and State Veterans Homes.
participantsVeterans, aged 65 years or older, who were acutely hospitalized and discharged to an SNF; one transition was randomly selected per patient. MEASUREMENTS: Adverse "transitional care" outcomes were a composite of hospital readmission, emergency department visit, or mortality within 7 days of hospital discharge.
resultsMore than four in five veteran transitions (81.7%) occurred entirely outside the VA system. The overall 7-day outcome rate was 10.7% in the 388 339 veterans included. Adverse outcomes were lowest in VA hospital-CLC transitions (7.5%; 95% confidence interval [CI] = 7.1%-7.8%) and highest in non-VA hospital to VA-contracted nursing home transitions (17.5%; 95% CI = 16.0%-18.9%) in unadjusted analysis. In multivariate analyses adjusted for patient and hospital characteristics, VA hospitals had lower adverse outcome rates than non-VA hospitals (odds ratio [OR] = 0.80; 95% CI = 0.74-0.86). In comparison to VA hospital-VA CLC transitions, non-VA hospital to VA-contracted nursing homes (OR = 2.51; 95% CI = 2.09-3.02) and non-VA hospital to CLC (OR = 2.25; 95% CI = 1.81-2.79) had the highest overall adverse outcome rates.
conclusionMost veteran hospital-SNF transitions occur outside the VA, although adverse transitional care outcomes are lowest inside the VA. These findings raise important questions about the VA's role as a provider and payer of post-acute care in SNFs. J Am Geriatr Soc 67:1820-1826, 2019.
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