Specialty care decreases once patients move into a nursing home: study

A study by researchers at Boston-based Harvard Medical School researchers found specialty care visits fell after patients moved into a nursing home.

The study, published in the Journal of the American Geriatrics Society in November, followed more than 39,000 people a year before and after they transitioned into nursing home residency. Resident information was taken from the Minimum Data Set and a 20 percent sample of Medicare fee-for-service claims from 2014 through 2018.

Among participants, 45.5 percent had a prior specialist visit 13 to 24 months before entering a nursing home. After becoming a nursing home resident, specialty visits decreased dropped by different percentages depending on the diagnoses and specialty:

  • Neurology in patients with multiple sclerosis dropped 0.9 percent.

  • Orthopedics dropped 14.4 percent.

  • Psychiatry dropped 67.9 percent.

Among residents who continued to visit specialists, 78.9 percent saw the same provider as before the transition.

In an editorial accompanying the study, Lauren Gerlach, DO, and Donovan Maust, MD, geriatric psychiatrists with Ann Arbor-based Michigan Medicine, wrote that the drop in psychiatric care was particularly concerning. More than 30 percent of nursing home residents have anxiety or depression, and the number of residents with a severe mental illness has increased 17 percent since 2017, according to the editorial. 

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