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Medicare patients at risk of long-term institutionalization after hospital stay
Date:10/3/2011

GALVESTON -- Confirming many elderly patients' worst fears, a national study has shown that being hospitalized for an acute event, such as a stroke or hip fracture, can lead to long-term institutionalization in a nursing home. Equally alarming, researchers found that direct discharge to a skilled nursing facility -- a common practice designed to reduce hospital stays -- put patients at "extremely high risk" of needing long-term nursing home care.

According to researchers at the University of Texas Medical Branch in Galveston, these findings suggest that programs aimed at helping older patients recuperate successfully at home instead of in an institutional setting could greatly improve their health outcomes and reduce healthcare costs. The study is published online today in the Journal of Gerontology.

"Hospitalization is a tipping point for older patients, often reducing their ability to live as independently as before," said lead author James S. Goodwin, MD, Director, Sealy Center on Aging at UTMB and the George & Cynthia Mitchell Distinguished Chair in Geriatric Medicine.

Goodwin also noted that certain factors common among the elderly -- cognition problems, frailty, lack of social support -- increase the risk of nursing home institutionalization.

"Add the enormous systemic pressure to reduce hospital stays and a dearth of viable programs to help patients fully recover their health and independence after hospitalization, and there simply isn't a clear path to get the patient back home," he said.

Medicare pays 100 percent for 20 days at a skilled nursing facility for patients who have just been released from the hospital but still need extra care.

"There is a very narrowly defined view of what Medicare will provide post-hospital," said Goodwin. "If Medicare payment guidelines were broadened to cover in-home care -- bathing and food preparation for example -- there is a tremendous potential for savings and patients could a
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Contact: Brianne ODonnell
brianne.odonnell@gabbe.com
212-220-4444
The Gerontological Society of America
Source:Eurekalert

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