Outcomes of Patients With Cancer Discharged to a Skilled Nursing Facility After Acute Care Hospitalization

Abstract

<jats:p><jats:bold>Background:</jats:bold> After discharge from an acute care hospitalization, patients with cancer may choose to pursue rehabilitative care in a skilled nursing facility (SNF). The objective of this study was to examine receipt of anticancer therapy, death, readmission, and hospice use among patients with cancer who discharge to an SNF compared with those who are functionally able to discharge to home or home with home healthcare in the 6 months after an acute care hospitalization. <jats:bold>Methods:</jats:bold> A population-based cohort study was conducted using the SEER-Medicare database of patients with stage II–IV colorectal, pancreatic, bladder, or lung cancer who had an acute care hospitalization between 2010 and 2013. A total of 58,770 cases were identified and patient groups of interest were compared descriptively using means and standard deviations for continuous variables and frequencies and percentages for categorical variables. Logistic regression was used to compare patient groups, adjusting for covariates. <jats:bold>Results:</jats:bold> Of patients discharged to an SNF, 21%, 17%, and 2% went on to receive chemotherapy, radiotherapy, and targeted chemotherapy, respectively, compared with 54%, 28%, and 6%, respectively, among patients discharged home. Fifty-six percent of patients discharged to an SNF died within 6 months of their hospitalization compared with 36% discharged home. Thirty-day readmission rates were 29% and 28% for patients discharged to an SNF and home, respectively, and 12% of patients in hospice received &lt;3 days of hospice care before death regardless of their discharge location. <jats:bold>Conclusions:</jats:bold> Patients with cancer who discharge to an SNF are significantly less likely to receive subsequent oncologic treatment of any kind and have higher mortality compared with patients who discharge to home after an acute care hospitalization. Further research is needed to understand and address patient goals of care before discharge to an SNF.</jats:p>

Effect of individualized psychological intervention on negative emotion and sleep quality of patients after bladder cancer surgery: a randomized controlled trial

“…The treatment of cancer lies not only in the disease itself and prolonging survival time, but also in improving quality of life (10,11). Long-term continuous negative emotions will affect the endocrine system, central nervous system, and other functions, causing many undesirable consequences (12,13). In this article, the control group adopted the traditional clinical nursing model, and the observation group had strengthened individualized psychological intervention on the basis of the routine nursing model.…”

Epidemiology and Outcomes of Hospitalizations Due to Hepatocellular Carcinoma

“…Patients who discharge to facilities such as SNF are typically older, more medically complex, and have higher hospital readmission rates than those who are strong enough to discharge home [ 31 , 53 , 54 ]. Among HCC hospitalizations, we found that discharge to facility was associated with increasing age, paralysis, psychosis, and neurological diseases.…”

“…Although there was no significant trend in the HCC hospitalizations discharged to facility, cancer patients discharged to facility have poor outcomes. For example, the mortality within six months was 56% among patients with colorectal, pancreatic, bladder, or lung cancer discharged to facility compared with 36% discharged home [ 31 ]. Readmission within 30 days from facility among Medicare beneficiaries is also higher [ 32 , 55 ].…”

“…Poor outcome was defined as in-hospital mortality or discharge to facilities. Among adult patients, discharge to facility such as SNF is associated with higher mortality and readmissions [ 31 , 32 ]. To identify the predictors of poor outcomes (in-hospital mortality and discharge to facility), we performed multivariable logistic regression with covariates that included demographic and hospital-level characteristics, and multiple comorbid conditions, and the results are presented as OR with 95% CI.…”

Analysis of the effect of a root cause analysis in elderly patients with acute pancreatitis: a randomized trial

“…Its main disease is the activation of pancreatic enzyme activity due to a variety of pathogenic factors (including excessive drinking and overeating, biliary diseases and alcohol abuse), which leads to severe consequences such as pancreatitis, hemorrhage, necrosis, systemic inflammatory response syndrome and multiple organ failure (1). Mild AP is usually selflimiting and has a good prognosis (2,3). Moderate or…”