Evidence map›Paper›PMID 33969480›Full record

ArticleHealth services research2021

The effects of vertically integrated care on health care use and outcomes in inpatient rehabilitation facilities.

Neeraj Sood, Victoria Shier, Peter J Huckfeldt, Lianna Weissblum, José J Escarce

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
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  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Neeraj SoodLeonard D. Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA.ORCID 0000-0001-9805-213X
Victoria ShierLeonard D. Schaeffer Center for Health Policy and Economics, Sol Price School of Public Policy, University of Southern California, Los Angeles, California, USA.
Peter J HuckfeldtDivision of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.ORCID 0000-0003-1593-4167
Lianna WeissblumMedtronic, Plc, Minneapolis, Minnesota, USA.
José J EscarceDavid Geffen School of Medicine at UCLA, California, Los Angeles, USA.
University of Southern California · USMedtronic (United States) · USUniversity of California, Los Angeles · USUniversity of Minnesota · US

Funding

Vertical Integration and Care Coordination in Post-Acute Care MarketsR01AG046838 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI SOOD, NEERAJ · 2014 to 2017
$2.8M
NIA NIH HHS R01 AG046838
6 · The paper itself

Abstract

objectiveTo understand the effects of receiving vertically integrated care in inpatient rehabilitation facilities (IRFs) on health care use and outcomes. DATA SOURCES: Medicare enrollment, claims, and IRF patient assessment data from 2012 to 2014. STUDY

designWe estimated within-IRF differences in health care use and outcomes between IRF patients admitted from hospitals vertically integrated with the IRF (parent hospital) vs patients admitted from other hospitals. For hospital-based IRFs, the parent hospital was defined as the hospital that owned the IRF and co-located with the IRF. For freestanding IRFs, the parent hospital(s) was defined as the hospital(s) that was in the same health system. We estimated models for freestanding and hospital-based IRFs and for fee-for-service (FFS) and Medicare Advantage (MA) patients. Dependent variables included hospital and IRF length of stay, functional status, discharged to home, and hospital readmissions. DATA EXTRACTION

methodsWe identified Medicare beneficiaries discharged from a hospital to IRF. PRINCIPAL

findingsIn adjusted models with hospital fixed effects, our results indicate that FFS patients in hospital-based IRFs discharged from the parent hospital had shorter hospital (-0.7 days, 95% CI: -0.9 to -0.6) and IRF (-0.7 days, 95% CI: -0.9 to -0.6) length of stay were less likely to be readmitted (-1.6%, 95% CI: -2.7% to -0.5%) and more likely to be discharged to home care (1.4%, 95% CI: 0.7% to 2.0%), without worse patient clinical outcomes, compared to patients discharged from other hospitals and treated in the same IRFs. We found similar results for MA patients. However, for patients in freestanding IRFs, we found little differences in health care use or patient outcomes between patients discharged from a parent hospital compared to patients from other hospitals.

conclusionsOur results indicate that receiving vertically integrated care in hospital-based IRFs shortens institutional length of stay while maintaining or improving health outcomes.

Indexed as

AgedAged, 80 and overDelivery of Health Care, IntegratedFee-for-Service PlansFemaleHealth ServicesHumansInpatientsInsurance Claim ReviewLength of StayMaleMedicareOutcome Assessment, Health CarePatient Acceptance of Health CarePatient ReadmissionRehabilitation CentershospitalsMedicarepostacute carereferrals and referral networksrehabilitation servicesvertical integration

Identifiers

PMID33969480
PMCPMC8522568
OpenAlexW3163181751

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.