Care‐Partner Support and Hospitalization in Assisted Living During Transitional Home Health Care

Wang, Jinjiao; Ying, Meiling; Temkin‐Greener, Helena; Caprio, Thomas V.; Yu, Fang; Simning, Adam; Conwell, Yeates; Li, Yue

doi:10.1111/jgs.17005

Cited by 1 publication

(4 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although we controlled for numerous measures of health status, there are likely a number of unobservable characteristics that may vary across discharge referrals and could influence the risk of outcomes. Therefore, though prior evidence has suggested unmet needs of AL residents after hospital discharge (e.g., medication administration and symptom monitoring 19 ), this study is unable to ascertain the specific reasons for differences in acute care readmissions across the different post‐acute care settings.…”

Section: Discussionmentioning

confidence: 91%

“…Further, the majority (83.3%) of AL staff are unlicensed personnel (e.g., personal care aides) and only 16% are licensed personnel (e.g., registered nurses [6.1% and licensed practical nurses [9.9%]) 2 . The need for more skilled post‐acute care among AL residents after hospital discharge may not be met on site 19 and necessitates additional support. Moreover, because AL communities are regulated at the state level, much variation exists in the availability and type of services provided in the AL 44 .…”

Section: Discussionmentioning

confidence: 99%

“…By virtue of staying in a structured residential setting, AL residents may have greater access to certain services (e.g., meal preparation, social interaction, and group‐guided exercise) than community‐dwelling older adults. Yet, earlier research has suggested that ALs may not be equipped to provide sufficient support for the residents after hospital discharge, 19 questioning the adequacy of post‐acute care support ALs can provide to residents. Moreover, there is a possibility that ALs may be cautious and/or unable to assume responsibility for post‐acute care and be incentivized to advocate other referrals for their residents rather than have them discharged back to the AL.…”

Section: Introductionmentioning

confidence: 99%

“…18 AL residents face unique situations and challenges in the post-acute care transitions. First, AL residents have a greater risk for certain outcomes in the post-acute care period, such as hospital readmissions, 19,20 indicating that AL residents may need more intensive post-acute care support than the general older population in the community. By virtue of staying in a structured residential setting, AL residents may have greater access to certain services (e.g., meal preparation, social interaction, and group-guided exercise) than community-dwelling older adults.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Post‐acute care transitions and outcomes among medicare beneficiaries in assisted living communities

Wang

Mao

McGarry

et al. 2022

J American Geriatrics Society

Self Cite

View full text Add to dashboard Cite

Background Despite the rapid growth of assisted living (AL) and frequent hospitalizations among AL residents, little is known about their patterns of post‐acute care transitions and outcomes. This study examined the post‐acute care transitions among AL residents and their association with outcomes in the first 30 and 60 days after hospital discharge. Methods This study used data from 2018 national Medicare enrollment and claims datasets, the Minimum Data Set (MDS), and Medicare Provider Analysis and Review (MedPAR) of 104,497 unique Medicare beneficiaries residing in ALs in the U.S. Post‐acute care referrals, based on hospital discharge status, to skilled nursing facilities (SNF), home with home health care (HHC), home without HHC, and other settings. Outcomes included 30‐day and 60‐day hospital readmissions, emergency department (ED) visits, long‐stay care nursing home placement, and mortality. Multinomial logistic regression analysis and logistic regression analysis were conducted. Results The most common post‐acute care referral was to SNF (40%), followed by home without HHC (28%), home with HHC (17%), and others (15%). Compared to discharge home without HHC, discharge to SNF was associated with a lower likelihood of ED visits (Odds Ratio = 0.597, p < 0.01) and hospital readmissions (OR = 0.856, p < 0.001), and higher likelihood of long‐stay nursing home placement (OR = 11.224, p < 0.01) and mortality (OR = 2.025, p < 0.01). Discharge home with HHC was associated with a higher likelihood of hospital readmissions (OR = 1.148, p < 0.01) and a lower likelihood of long‐stay nursing home placement (OR = 0.737, p < 0.05) than discharge home without HHC. The results were similar within the first 30 days as well as 60 days after hospital discharge. Conclusions AL residents who are discharged to different post‐acute care settings tend to differ in 30‐day and 60‐day outcomes. At hospital discharge, clinicians and discharge planners should be provided information about the exact type and availability of services at AL to make the most appropriate discharge referrals for AL residents.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%