The following is a summary of “Patient Outcomes After Long-Term Acute Care Hospital Closures,” published in the November 2023 issue of Critical Care Medicine by Law et al.
For a retrospective study, researchers examined the impact of long-term acute care hospitals (LTCHs) closure on patient care patterns and outcomes in short-stay hospitals. They aimed to understand how the closure of LTCHs between 2012 and 2018 affected care patterns and outcomes at short-stay hospitals. The study’s timeframe for data analysis spanned from October 2022 to June 2023.
Between 2011 and 2019, nearly 99,500 patients underwent mechanical ventilation for over 96 hours at around 1,200 hospitals. Among these, 84 LTCHs closed down. An analysis covering over 8,400 patients aged around 76, conducted at 45 hospitals affected by LTCH closures and 45 matched-control hospitals, revealed important impacts. The closures of LTCHs were linked to reduced transfer rates to LTCHs and lowered spending-per-days-alive. In patients who had received a tracheostomy, there was an increase in do-not-resuscitate orders and transfers to skilled nursing facilities. However, the closure didn’t significantly correlate with 90-day mortality rates.
The study findings indicated that the closure of LTCHs had discernible effects on discharge patterns among patients on extended mechanical ventilation and those who had undergone a tracheostomy. No significant change in mortality rates was observed. However, further extensive research is warranted to gain a comprehensive understanding of LTCH availability’s impact on critical outcomes such as functional recovery and patient-family satisfaction.
Source: jamanetwork.com/journals/jamanetworkopen/fullarticle/2812084
