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Readmissions Up for Preexisting HAIs With Home Discharge

Risk for readmission for preexisting health care-associated infection lower with discharge to SNF

TUESDAY, Oct. 29, 2019 (HealthDay News) — Discharge to a skilled nursing facility (SNF) is associated with fewer avoidable readmissions for preexisting health care-associated infections (HAIs) compared with home discharges, according to a study published online Oct. 23 in the Journal of the American Geriatrics Society.

Geoffrey J. Hoffman, Ph.D., from the University of Michigan in Ann Arbor, and colleagues used 2013 to 2014 national hospital discharge data to estimate the likelihood of readmissions for preexisting HAIs according to patients’ discharge location (SNF, home health care, and home care without home health care [home]) and whether the likelihood varies according to patient comorbidity level across four common types of HAIs. The analysis included hospital discharges among Medicare beneficiaries (≥65 years).

The researchers found that among 702,304 index admissions involving HAI treatment, 50 percent were discharged to an SNF, 26 percent to home health care, and 24 percent to home. Of preexisting HAIs, 2.5 percent resulted in linked HAI readmissions, which were more common for Clostridioides difficile infections (4 percent) and urinary tract infections (2.4 percent) versus surgical-site infections (1.1 percent). Compared with home or home health care discharge, being discharged to an SNF was associated with a 38 percent lower risk for a linked HAI readmission. This difference in risk increased with greater patient comorbidity.

“There are probably some gaps in self-care for patients going home with an infection from the hospital,” Hoffman said in a statement. “This suggests home health care agencies aren’t up to snuff with infection control and patients going home without home health care probably need better training, as do their caregivers.”

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