ArticleChest2026
Post-ICU Care Trajectories and Outcomes Among Veterans: Comparing Veterans Affairs and Community Hospital Discharges.
Article in Chest, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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.
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.
Who cites it
2 citing papers in PubMed.
- Remote Monitoring Approaches to Reduce Readmissions After Infection and Sepsis: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Post-Intensive Care Fragmentation Among Rural Veterans: Transitions Between VA and Community Health Systems.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSurvivors of critical illness face fragmented care transitions, leading to readmissions, emergency care use, and death. The Veterans Affairs (VA) Patient Aligned Care Team model emphasizes coordinated outpatient follow-up, yet many veterans now receive VA-purchased intensive care at community hospitals, potentially disrupting continuity. RESEARCH QUESTION: How do outcomes after ICU care differ for veterans discharged from VA medical centers vs community hospitals, and what recovery trajectories emerge after discharge? STUDY DESIGN AND
methodsWe conducted a retrospective cohort study of 311,224 veterans discharged home after medical ICU admission (2016-2023) using VA Corporate Data Warehouse and VA-purchased care claims. Outcomes included primary care visits, emergency department (ED) use, readmissions, mortality, and hospital-free days. Fine-Gray subdistribution hazard models estimated 30-day and 90-day risks, accounting for competing risks and adjusting for demographics, comorbidities, and facility clustering. Marginal standardization yielded adjusted risks, risk differences, and hazard ratios. A Bayesian mediation analysis tested whether 30-day primary care follow-up mediated readmission risk. Weekly transitions across 5 states-home, primary care visit, ED visit, readmission, and death-were analyzed with state sequence clustering.
resultsOf 311,224 survivors of ICU stays, 36.9% were discharged from VA hospitals and 63.1% were discharged from community hospitals. At 30 days, patients from VA hospitals showed higher primary care follow-up rates (20.2% vs 15.3%), but higher 90-day readmission rates (27.0% vs 24.4%) and mortality rates (8.4% vs 7.3%). Patients discharged from community hospitals relied more on ED visits (32.1% vs 25.7%). Mediation analysis showed early primary care was protective, but explained little of the VA-community difference. Trajectory clustering revealed diverse recovery patterns, ranging from high primary care with low readmission to recurrent acute care use or early death.
interpretationOur results showed that patients discharged from VA hospitals received earlier primary care, but showed higher readmission and mortality, whereas patients discharged from community hospitals made fewer visits but more ED use, highlighting the need for structured, risk-stratified transitional care.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.