Prevalence of subacute patients in acute care: results of a study of VA hospitals.
Subacute care is a transitional level of care for medically stable patients who no longer require daily diagnostic/invasive care but require more intensive care than is typical in a skilled care facility. A Congressionally mandated study was undertaken to determine the number of VA patients with subacute needs being cared for in acute care. InterQual, Inc. subacute care criteria were retrospectively applied to 858 medical and surgical admissions from 43 VA hospitals. Over one-third contained at least one subacute day; with an average length of stay (LOS) of 12.7 days (SD = 12.4); of which 6.8 days were subacute. Patients with these admissions had significantly longer LOSs, were older, and were more likely to die or to be discharged to a nursing home. Diagnoses with subacute days included COPD, pneumonia, joint replacement, and cellulitis. Future studies should develop clinical pathways to prospectively manage admissions with subacute needs and then evaluate their effectiveness.
Weaver
F M
FM
Midwest Center for Health Services and Policy Research, Hines VA Hospital, IL 60141, USA.
Guihan
M
M
Hynes
D M
DM
Byck
G
G
Conrad
K J
KJ
Demakis
J G
JG
D000367:Age Factors; D019643:Arthroplasty, Replacement / Q000706:statistics & numerical data; D002481:Cellulitis / Q000453:epidemiology; D019091:Critical Pathways; D005069:Evaluation Studies as Topic; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008173:Lung Diseases, Obstructive / Q000453:epidemiology; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D011014:Pneumonia / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012866:Skilled Nursing Facilities; D019467:Subacute Care / Q000145:classification / Q000706:statistics & numerical data*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology