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Readmission Reduction Strategies for Patients Discharged to Skilled Nursing Facilities: A Case Study From 2 Hospital Systems in 1 City.
Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York.
Department of Health Services Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island.
Center for Gerontology and Healthcare Research, School of Public Health, Brown University, Providence, Rhode Island.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
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2019 (English)In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Some hospitals seek integration with skilled nursing facilities (SNFs) to reduce readmissions while others focus more on patients discharged home.

PURPOSE: Our objective was to understand different approaches for readmission reduction for patients discharged to SNFs based on contrasting strategies from 2 competing hospital systems.

METHODS: Employing a case study methodology, we compared 1 hospital system that integrated with SNFs to a competing system that did not. We compared interview data from clinical and administrative staff and publicly reported rehospitalization rate changes from the 2 systems.

RESULTS: Analysis of integrating hospital system interviews noted providing patients detailed discharge information and educating SNF staff regarding care protocols. Integrated hospital system all-cause readmission rates declined by nearly 1 percentage point more than the nonintegrated hospital system (coefficient, -0.008; 95% confidence interval, -0.003 to -0.012) between 2014 and 2017.

CONCLUSION: As hospitals explore care transition improvements to SNFs, developing more embedded relationships highlights one approach to improve value.

Place, publisher, year, edition, pages
2019.
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Medical and Health Sciences Health Care Service and Management, Health Policy and Services and Health Economy
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URN: urn:nbn:se:uu:diva-400185DOI: 10.1097/NCQ.0000000000000459PubMedID: 31834200OAI: oai:DiVA.org:uu-400185DiVA, id: diva2:1380445
Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2019-12-18

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