Survival among Medicare beneficiaries who have been transferred to long-term acute-care hospitals is poor, according to a study published in the June 9 edition of the
Journal of the American Medical Association.
To analyze long-term-care trends, researchers used the Medicare Provider Analysis and Review files from 1997 to 2006, which included all Medicare hospitalizations involving admission to an intensive-care unit of an acute-care, non-federal hospital in the continental U.S. The findings showed that the number of LTAC hospitals grew to 408 in 2006 from 192 in 1997, while the number of admissions to those facilities increased to 40,353 from 13,732, and costs rose to $1.32 billion from $484 million. In that time, the study showed, transferred patients had higher number of co-morbidities—5 from 1997 to 2000 compared with 5.8 between 2004 and 2006. Meanwhile, mortality rates remained high throughout the study period, increasing to 52.2% between 2004 and 2006 from 50.7% between 1997 and 2000, according to the study.
The Acute Long Term Hospital Association, which represents long-term-care facilities, released a statement regarding the study that said it welcomes the chance to engage in debate about the role of LTAC hospitals in the healthcare system.
“The authors have acknowledged their study has a number of limitations due to available data,” the ALTHA statement said of the findings. “To another degree, the study has also been overcome by recent events, including the new 2010 health reform law, which contains a number of new statutory mandates which will affect all hospitals for years to come; the recent lowering of our operating margins through regulatory changes; and a temporary moratorium imposed by Congress as CMS has been slow to develop certification criteria for our hospitals.”
