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Lead author James S. Goodwin, MD, Director, Sealy Center on Aging at UTMB noted that certain factors common among the elderly -- cognition problems, frailty, lack of social support -- increase the risk of nursing home institutionalization. Goodwin and his colleagues measured a five percent sample of Medicare enrollees (approximately 762,000) aged 66 or older between 1996 and 2008 who were admitted to nursing homes. Of that population, 75 percent were admitted to a nursing home for long-term care within six months of a hospital stay. This correlated to Medicare's adoption of a prospective payment system that encouraged hospitals to reduce the length of stays. Researchers also found several factors that reduced the risk of long-term institutionalization. Patients cared for in larger hospitals and major teaching hospitals were less likely to be in a nursing home six months after discharge, as were patients treated by their primary care physicians. Goodwin recommends that hospitals consider alternatives to skilled nursing facilities post-hospitalization, such as community-based facilities, assisted living facilities and at-home care. And that is a lesson for us. Understand what the discharge options are for your hospital and consider a hospital that offers options for rehabilitating at home. |
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