A Regional Analysis of Patient Outcomes and Medicare Payments for Sepsis Patients Treated in Long-Term Care Hospitals and Skilled Nursing Facilities

In this study, we compare mortality, readmissions and Medicare payments for long-term care hospital (LTCH) patients who had a short-term acute care hospital (STACH) stay for sepsis and similar patients cared for in SNFs in the Chicago area. The study population consisted of Medicare beneficiaries who experienced an STACH stay for septicemia or severe sepsis (MS-DRG: 870, 871) between March 2011 and June 2013 in the Chicago area and were discharged to an LTCH or SNF.  Patients who were discharged to LTCHs immediately following the STACH stay constituted the treatment group.  We used propensity score matching to construct a comparison group consisting of patients with similar characteristics receiving care in SNFs after the STACH stay.  We did not find statistically significant differences in mortality and Medicare payments between LTCH and SNF patients over 180-day episodes of care that started at admission to STACH (p>0.05).  However, LTCH patients experienced lower readmission rates within 30-days after discharge from STACH when compared to SNF patients (LTCH patients: 14% vs. SNF patients: 29%, p<0.05).  The difference in 60- and 90-day readmission rates between the two groups is statistically insignificant (p>0.05).

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