Variation in long-term acute care hospital use after intensive care.
Long-term acute care hospitals (LTACs) are an increasingly common discharge destination for patients recovering from intensive care. In this article the authors use U.S. Medicare claims data to examine regional- and hospital-level variation in LTAC utilization after intensive care to determine factors associated with their use. Using hierarchical regression models to control for patient characteristics, this study found wide variation in LTAC utilization across hospitals, even controlling for LTAC access within a region. Several hospital characteristics were independently associated with increasing LTAC utilization, including increasing hospital size, for-profit ownership, academic teaching status, and colocation of the LTAC within an acute care hospital. These findings highlight the need for research into LTAC admission criteria and the incentives driving variation in LTAC utilization across hospitals.
University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. kahnjm@upmc.edu
Jeremy M
JM
Kahn
Rachel M
RM
Werner
Shannon S
SS
Carson
Theodore J
TJ
Iwashyna
D000208:Acute Disease; D000368:Aged; D003422:Critical Care / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006302:Health Services Research; D016304:Hospitals, Private / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D006278:Medicare / Q000191:economics; D014481:United States