title: Patient and Hospitalization Characteristics Associated With Increased Postacute Care Facility Discharges From US Hospitals.
abstract: OBJECTIVE
  The number of patients discharged to postacute care (PAC) facilities after hospitalization increased by 50% nationally between 1996 and 2010. We sought to describe payors and patients most affected by this trend and to identify diagnoses for which PAC facility care may be substituting for continued hospital care.
  
  
  METHODS
  Retrospective analysis of the National Hospital Discharge Survey from 1996 to 2010.
  
  
  METHODS
  Adult discharges from a national sample of non-Federal hospitals.
  Adults admitted and discharged to a PAC facility between 1996 and 2010. Our analysis includes 2.99 million sampled discharges, representative of 386 million discharges nationally.
  
  
  METHODS
  Patient demographic and hospitalization characteristics, including length of stay (LOS) and diagnoses treated.
  
  
  RESULTS
  More than half (50.7%) of all patients discharged to PAC facilities were 80 years old or older in 2010; 40% of hospitalizations in this age group ended with a PAC stay. Decreases in LOS and increases in PAC facility use were consistent across payors and patient demographics. PAC facilities may be substituting for continued inpatient care for patients with pneumonia, hip fracture, and sepsis as these diagnoses demonstrated the clearest trends of decreasing LOS and increasing discharges to PAC facilities.
  
  
  CONCLUSIONS
  The rise in discharges to PAC facilities is occurring in all age groups and payors, though the predominant population is the very old Medicare patient, for whom successful rehabilitation may be most unsure. PAC facility care may be increasingly substituted for prolonged hospitalizations for patients with pneumonia, hip fracture, and sepsis.
authors.affiliation: *Department of Veterans Affairs Medical Center, Eastern Colorado Health Care System †Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Denver ‡Department of Biostatistics and Informatics, University of Colorado School of Public Health §Division of Health Care Policy and Research ∥Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Burke
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Juarez-Colunga
authors.forename: Cari
authors.initials: C
authors.lastname: Levy
authors.forename: Allan V
authors.initials: AV
authors.lastname: Prochazka
authors.forename: Eric A
authors.initials: EA
authors.lastname: Coleman
authors.forename: Adit A
authors.initials: AA
authors.lastname: Ginde
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019538:Health Care Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult