Patient Outcomes After Long-Term Acute Care Hospital Closures
Authors' conclusion
In this cohort study, LTCH closure was associated with changes in discharge patterns in patients receiving mechanical ventilation for at least 96 hours and advanced directive decisions in the subgroup receiving a tracheostomy, without change in mortality.
Study context
- Population
- Medicare fee-for-service beneficiaries aged 66 years and older receiving mechanical ventilation (MV) for at least 96 hours in an ICU, and the subgroup also receiving a tracheostomy, US, 2011 to 2019difference-in-differences analysis
- Participants
- 8,404 beneficiaries
- Exposure
- Closure-affected hospitals vs matched control hospitals
- Closure-affected hospitalsn = 45
- Control hospitalsn = 45reference
- Outcome
- Upstream care patterns (do-not-resuscitate orders, palliative care, tracheostomy placement, discharge disposition) and patient outcomes (hospital LOS, days alive and institution free, spending per days alive, 90-day mortality)
Methodological detailsnational, matched cohort, difference-in-differences analysis
- National
- Matched cohort
- Difference-in-differences analysis
Main finding
As reported in the abstract
LTCH transfer rates; spending per days alive within 90 days
LTCH closureDifference, percentage points (95% CI)
LTCH transfer rates
−5.1(−8.2 to −2.0)
Per days alive within 90 days, as printed
- Spending-per-days-alive
- difference -$8701.58 (95% CI -$13 323.56 to -$4079.60)
Observational data: associations, not effects.
Further findings
- No significant association of closure with 90-day mortality
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Patient Outcomes After Long-Term Acute Care Hospital Closures. JAMA Netw Open. Published 1 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →