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Interhospital variability in time to discharge to rehabilitation among insured trauma patients

The Journal of Trauma and Acute Care Surgery Mar 09, 2019

Knowlton LM, et al. - Given that hospital costs are partly influenced of the length of stay (LOS), which can be affected by the local availability of postacute care (PAC) resources (inpatient rehabilitation and skilled nursing facilities), particularly for injured patients, researchers examined the variation in LOS for trauma patients destined for PAC based on insurance type and hospitals from which they are discharged using the 2014 to 2015 National Inpatient Sample from the Healthcare Cost and Utilization Project. They identified 958,005 trauma patients that met the inclusion criteria. As per multivariate regression controlling for patient and hospital characteristics, Medicaid patients were noted to spend an additional 0.4 days in shortest LOS hospitals and an additional 2.6 days in longest LOS hospitals. Prolonged LOS is likely a function of access to postacute facilities, which is largely out of the hands of trauma centers. Access to postacute beds increased efficiencies in care. This support enhancing the availability of rehabilitation facilities, particularly for Medicaid patients, to reduce LOS.
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