Let’s start with an example. Jim is a 57-year-old general contractor. One day he begins experiencing blurred vision and a headache. He thinks he is exhausted from a hard day’s work and goes to sleep. The next morning, he isn’t able to speak or move his right arm. His wife rushes him to the emergency department where he is diagnosed with a stroke. Jim receives several days of inpatient care including speech and physical therapy. Once he is medically stable, it is determined he will need continued therapy for his stroke deficits.
Jim will now benefit from post acute care services. He may be transferred to another facility to continue rehabilitation or he may even receive these services at an outpatient center or in his own home.
Post acute care is growing across the country. Nearly 50% of patients discharged from an inpatient setting will receive some kind of post acute care. Here we will explore what post acute care is exactly and how it benefits patients and the healthcare system.
Care received after discharge from an acute care setting (usually a hospital) is post acute care. Hospitals, ambulatory care centers, and emergency departments offer care for a limited amount of time to treat a specific illness or injury. Once the patient is stable, which does not necessarily mean the illness or diagnosis is resolved, they are discharged.
Joint Commission on Accreditation of Healthcare Organizations, better known as JCAHO, defines post acute care as services for patients whose conditions have stabilized following acute hospitalization to facilitate their return to the community. In early development, post acute care was seen merely as an extension of acute care to limit costs and shorten inpatient care stays and was often incomplete necessitating the need for improved quality.
Think of post acute care as a transition or hand-off of care. Hospitals have partnerships or referral systems with specific providers to provide continuity of care. Post acute care facilities and services include:
This depends on the diagnosis, the extent of injury, and the level of care required. A patient recovering from a traumatic brain injury will require 24/7 care while a patient recovering from a fall and arm fracture may only need a few weeks of home health services. Common patient conditions treated in post acute settings include:
Promote continued recovery. Older adults in particular often require continued care following an illness as they usually have multiple chronic comorbidities and take longer to recover and return to their functional baseline. The goal of post acute care is to promote independence and quality of life and prevent complications. Studies in Taiwan showed that mortality decreased, ADLs and cognition increased, and pain and depression improved when receiving post acute care.
Prevent readmissions. Medicare hates paying for excess medical care. So much so, that if a patient is readmitted within 30 days of discharge with the same diagnosis, Medicare reduces their reimbursement to the hospital. This makes post acute care so valuable in preventing readmissions.
Cost savings. It isn’t hard to understand why advancing age correlates with increasing access to medical care. Interestingly enough, research shows that despite our growing aging population, the number of acute hospitalization days has declined. Post acute care was originally developed as a way to reduce the length of acute care admissions which would decrease medical costs.
Reduce healthcare burden. All of these benefits combined create a reduction in healthcare burden. By preventing complications, increasing health and recovery, reducing readmissions, and saving money, less burden is placed on the healthcare system as a whole.
It may seem confusing that a skilled nursing facility (SNF) is a post acute facility. Patients are sometimes transferred into SNFs to continue several weeks of intensive therapy. While patients may receive post acute care for an extended period, this isn’t the same as when an elderly patient is placed in a SNF or retirement setting. The best way to explain the difference is that patients who receive post acute care have the end goal of returning home, while those receiving long-term care are home.
As the population continues to age, the need for additional and more strategic post acute care will rise. Advancements in technology through telehealth and virtual monitoring will improve follow-up care and recognition of complications. The development of programs for seniors and chronic conditions as well as new models of care will be sought after to educate and prevent hospital admissions as well as manage and achieve optimal recovery.
Advantis Medical staffs nurses and allied professionals in many post acute care settings. Browse our job board to find the perfect location and facility to match your skills.