Physician visits crucial for patients at skilled nursing facilities, study finds

Patients at skilled nursing facilities who received no visits from a physician or advanced practitioner experienced hospital readmission rates twice as high as those who had at least one visit, according to a study published in Health Affairs.

Researchers examined Medicare fee-for-service claims data for a group of beneficiaries discharged from acute care hospitals to skilled nursing facilities between January 2012 and October 2014. In all, they studied 2 million Medicare fee-for-service skilled nursing facility stays. About 10.4 percent of patients had no physician or advanced practitioner visit during their entire stay, which had a median duration of 11 days.

Researchers found patients who did not have physician or advanced practitioner visits had 30-day hospital readmission rates twice that of patients with at least one visit. Additionally, twice as many patients who had no visits died within 30 days of admission to the skilled nursing facility.

Those patients who did not receive clinician visits had lower rates of successful discharge to the community as compared to counterparts with at least one visit.

The study also shows that skilled nursing facilities that were small, rural and in the South or the Midwest tended to either not conduct initial assessments of patients admitted to their facilities or conducted them later compared to those that were larger, urban and in the Northeast.

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