Selecting post-acute care settings after abdominal surgery: Are we getting it right?

Courtney J. Balentine, Glen Leverson, David J. Vanness, Sara Knight, Janet Turan, Cynthia J. Brown, Herb Chen, Smita Bhatia

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: We investigated whether variation in post-acute care (PAC) services could be explained by surgeons discharging clinically similar patients to different PAC destinations, including home health (HH), skilled nursing facilities (SNF), and inpatient rehabilitation (IR). Methods: We studied patients having colectomy, pancreatectomy or hepatectomy in the 2008–2011 Nationwide Inpatient Sample. We used propensity matching to determine: 1. Proportion of patients discharged to SNF/IR who could be matched to clinically similar patients discharged with HH. 2. Potential cost savings from greater use of HH. Results: 30,843 patients were discharged with HH and 23,172 to SNF or IR. 14,163 (61%) SNF/IR patients could be matched to similar patients discharged with HH. Potential cost savings from increasing use of HH as an alternative to SNF/IR ranged from $2.5-$438 million annually. Conclusions: There is considerable potential for reducing variation in PAC use and costs by better understanding how surgeons make decisions about PAC placement.

Original languageEnglish (US)
Pages (from-to)260-266
Number of pages7
JournalAmerican journal of surgery
Volume216
Issue number2
DOIs
StatePublished - Aug 2018
Externally publishedYes

Fingerprint

Subacute Care
Skilled Nursing Facilities
Inpatients
Rehabilitation
Health
Cost Savings
Home Health Nursing
Pancreatectomy
Colectomy
Hepatectomy
Costs and Cost Analysis

Keywords

  • Care transitions
  • Cost-effectiveness
  • Post-acute care
  • Post-discharge care
  • Postoperative recovery

ASJC Scopus subject areas

  • Surgery

Cite this

Selecting post-acute care settings after abdominal surgery : Are we getting it right? / Balentine, Courtney J.; Leverson, Glen; Vanness, David J.; Knight, Sara; Turan, Janet; Brown, Cynthia J.; Chen, Herb; Bhatia, Smita.

In: American journal of surgery, Vol. 216, No. 2, 08.2018, p. 260-266.

Research output: Contribution to journalArticle

Balentine, CJ, Leverson, G, Vanness, DJ, Knight, S, Turan, J, Brown, CJ, Chen, H & Bhatia, S 2018, 'Selecting post-acute care settings after abdominal surgery: Are we getting it right?', American journal of surgery, vol. 216, no. 2, pp. 260-266. https://doi.org/10.1016/j.amjsurg.2017.08.043
Balentine, Courtney J. ; Leverson, Glen ; Vanness, David J. ; Knight, Sara ; Turan, Janet ; Brown, Cynthia J. ; Chen, Herb ; Bhatia, Smita. / Selecting post-acute care settings after abdominal surgery : Are we getting it right?. In: American journal of surgery. 2018 ; Vol. 216, No. 2. pp. 260-266.
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