Trends in Post-Acute Care Utilization During the COVID-19 Pandemic.
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 ANDPARTICIPANTS:
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.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
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