Your browser doesn't support javascript.
Trends in Post-Acute Care Utilization During the COVID-19 Pandemic.
Werner, Rachel M; Bressman, Eric.
  • Werner RM; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA. Electronic address: rwerner@upenn.edu.
  • Bressman E; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.
J Am Med Dir Assoc ; 22(12): 2496-2499, 2021 12.
Article in English | MEDLINE | ID: covidwho-1401568
ABSTRACT

OBJECTIVE:

To examine the effect of the COVID-19 pandemic on post-acute care utilization and spending.

DESIGN:

We used a large national multipayer claims data set from January 2019 through October 2020 to examine trends in posthospital discharge location and spending. SETTING AND

PARTICIPANTS:

We identified and included 975,179 hospital discharges who were aged ≥65 years.

METHODS:

We summarized postdischarge utilization and spending in each month of the study (1) the percentage of patients discharged from the hospital to home for self-care and to the 3 common post-acute care locations home with home health, skilled nursing facility (SNF), and inpatient rehabilitation; (2) the rate of discharge to each location per 100,000 insured members in our cohort; (3) the total amount spent per month in each post-acute care location; and (4) the percentage of spending in each post-acute care location out of the total spending across the 3 post-acute care settings.

RESULTS:

The percentage of patients discharged from the hospital to home or to inpatient rehabilitation did not meaningfully change during the pandemic whereas the percentage discharged to SNF declined from 19% of discharges in 2019 to 14% by October 2020. Total monthly spending declined in each of the 3 post-acute care locations, with the largest relative decline in SNFs of 55%, from an average of $42 million per month in 2019 to $19 million in October 2020. Declines in total monthly spending were smaller in home health (a 41% decline) and inpatient rehabilitation (a 32% decline). As a percentage of all post-acute care spending, spending on SNFs declined from 39% to 31%, whereas the percentage of post-acute care spending on home health and inpatient rehabilitation both increased. CONCLUSIONS AND IMPLICATIONS Changes in posthospital discharge location of care represent a significant shift in post-acute care utilization, which persisted 9 months into the pandemic. These shifts could have profound implications on the future of post-acute care.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: J Am Med Dir Assoc Journal subject: History of Medicine / Medicine Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Country/Region as subject: North America Language: English Journal: J Am Med Dir Assoc Journal subject: History of Medicine / Medicine Year: 2021 Document Type: Article