Reducing Hospital Readmission from Skilled Nursing Facilities to Reduce Healthcare Costs and Improve Quality of Care

Abstract

Patients discharged to skilled nursing facilities after hospital stays experience high readmission rates due to insurance mandating length of stay. This study used mixed methods to determine patient characteristics that contribute to readmissions and develop recommendations to reduce readmissions. The medical records of 241 patients discharged from a skilled nursing facility (SNF) were reviewed to identify common characteristics of individuals who readmitted in 30 or 60 days. Data was analyzed using an independent samples t-test and binary logistic regression analysis. There was a significant difference in average SNF length of stay, number of comorbidities, and self-care and mobility scores of patients readmitted in 30 days and those who did not. There was a significant difference in SNF length of stay, more comorbidities, self-care and mobility scores, and number of risk factors of patients readmitted in 60 days and those who did not. Binary logistic regression showed short SNF length of stay, congestive heart failure, and more comorbidities predicted a readmission in 30 days. Similarly, diabetes, more comorbidities, and not receiving home health predicted readmissions in 60 days. Qualitative data was collected from patient interviews to gain perspectives on the quality of care at the SNF and therapist surveys to determine their understanding of readmissions and their proposed solutions for readmissions. Recommendations included improving communication between staff and patients, increasing patient education, and providing therapy discharge instruction to ensure successful discharge. The results propose possible reasons for readmissions and ways to reduce them to improve patient outcomes and decrease healthcare spending.