Less Home Care Used in Rural Areas
March 17, 2017 02:39 PM
Rural patients receive less post-acute care after hospital discharge than urban patients, according to a new study published in The American Journal of Managed Care.
The study looked at 1.56 million hospital discharges of urban and rural patients and found just 12.1 percent were rural patients discharged to post-acute care (PAC), which would include either home health or a skilled nursing facility. Rural patients receive less PAC after a hospital discharge than other patients.
The survey studied how different diagnoses impacted PAC results in urban and rural areas and found, to take one prominent example, that patients in rural areas who received elective joint arthroplasty (a surgical procedure to restore the function of a joint) were 41 percent less likely to receive PAC of any sort, compared to other diagnoses.
This matters because post-acute care can have a huge impact on patient success, particularly for certain conditions. The study found that after hip replacements or strokes patients may not recover as well if treated at hospitals that use less home health and more skilled nursing facilities.
All this goes directly to the access, or lack thereof, people in rural areas have to home care and hospice, something noted by the authors of the study – and a frequent point made by NAHC. “Rural patients at rural hospitals received significantly more SNF care and significantly less HHC overall in six of the top 10 most commonly treated diagnoses,” according to the authors.
The higher use of skilled nursing facilities in rural areas is leading to higher health care costs, with the average cost of a stay in a skilled nursing facility costing $11,357, which compares to only $2720 for home health, the study found.
The study concludes that these differences in cost are key to determining how to improve patient success after discharge from hospital and how to maintain control of health care spending. Once again, we find that home health care beats the alternatives, not only in patient outcome, but in controlling cost.