Long-Term Acute Care Hospital Utilization Increasing

But survival among patients transferred to these facilities after critical illness episode is poor
By Lindsey Marcellin
HealthDay Reporter

TUESDAY, June 8 (HealthDay News) -- Hospitalizing patients in long-term acute care hospitals after critical illness is an expensive but increasingly utilized option, according to research published in the June 9 issue of the Journal of the American Medical Association.

Jeremy M. Kahn, M.D., of the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective cohort study of Medicare beneficiary transfers to long-term acute care hospitals after an episode of critical illness. Measured outcomes were overall long-term acute care utilization, as well as the costs of care, and the survival rate after the transfer.

The researchers found that the number of these hospitals increased from 192 in 1997 to 408 in 2006, while the number of admissions to them nearly tripled during the same period, from 13,732 to 40,353; the annual cost increased to $1.325 billion from $484 million. The population incidence (standardized for age) of admissions to these facilities increased from 38.1 to 99.7 per 100,000 over that time period, and the number of comorbidities per patient increased as well. One-year mortality after admission to a long-term acute care hospital was 52.2 percent in 2004 to 2006, compared with 50.7 percent in 1997 to 2000.

"Our results underscore the capability of the medical system to adopt new organizational innovations and highlight the need for a diverse program of comparative effectiveness research to determine the optimal organization of care for patients recovering from critical illness, including the best way to maximize survival and control costs for this high-risk patient group," the authors write.

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