Use of Long-Term Acute Care Hospitalization Growing

An increasing number of older Americans are being admitted to long-term acute care hospitals after they've been treated for a critical illness, a new study found.

Researchers analyzed Medicare data from 1997 to 2006. During that time, the number of long-term acute care hospitals doubled from 192 to 408, the percentage of Medicare patients who were transferred to a long-term acute care hospital after a critical illness tripled from 0.7% of patients to 2.5% of patients, total associated costs increased from $484 million to $1.325 billion, and the one-year survival for these patients was poor.

"Over time, transferred patients had higher numbers of [coexisting illnesses] [5 in 1997-2000 vs. 5.8 in 2004-2006] and were more likely to receive mechanical ventilation at the long-term acute care hospital [16.4% in 1997-2000 vs. 29.8% in 2004-2006]," wrote study author Jeremy M. Kahn, MD, MSc, of the University of Pennsylvania in Philadelphia, and colleagues.

The rates of death within one year of long-term acute care hospital admission were high throughout the entire study period: 50.7% in 1997-2000 and 52.2% in 2004-2006, the authors pointed out.

"The clinical and economic burden of patients with chronic critical illness is significant and likely to expand with the aging of the population and advances in critical care that increase patient survival. Long-term outcomes of the chronically critically ill are poor, with substantial need for new approaches to their care. We demonstrate that long-term acute care hospitals play an increasingly important role in patients with chronic critical illness, despite scant data to guide decision making about transfer or inform policy decisions about whether to support or restrict this rapidly growing cost center," Kahn and colleagues wrote in the Journal of the American Medical Association.

Source: Brigham and Women's Hospital