Post acute care: cui prodest? A 1-year retrospective observational study
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Medical Urgency and Post-Acute Care, Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
Department of Internal Medicine, Medical Urgency and Post-Acute Care, Azienda Ospedaliero-Universitaria di Modena, Italy
Post-Acute Care, Department of Internal Medicine, Medical Urgency and Post-Acute Care
Azienda Ospedaliero-Universitaria (AOU) di Modena, Italy
Management, Azienda Ospedaliero-Universitaria di Modena, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A12
Background: At the time of discharge from acute care (AC) hospital, many old patients are unable to return home and need a short or extended stay at skilled medical and nursing facilities in the hospital, post-acute care (PAC),  for clinical stabilization and/or reactivation/rehabilitation. This work analyzes the characteristics of patients that needed hospitalization in PAC and the benefit for patients and hospital. methods We checked consecutively 272 patient’s requests of transfer records from January 1 to December 31,2020. We considered age, sex, assessment of the patients suitability for transfer and date, day of transfer to PAC, date and type of discharge, diagnosis, re-hospitalization, death during hospitalization or within 3-6 months etc. Results: 12 patients (4,4%) were considered not suitable for PAC; 95 woman and 82 male were transfer to PAC; 45 woman and 38 male considered suitable were not transfer for “lack of beds”. 26 patients (14,6%) transfer to PAC needed palliation versus 12 remained in AC. Patients discharged from PAC versus not transfer, due to “lack of beds”, were fewer re-hospitalized at one and 3 months (7,3% vs 12%) and (14,6 % vs 22,9%). For lack of beds in PAC, patients remained in AC 2116 days and were considered “bed blockers” long this period. In Italy PAC is remunerated "on a day" (about 150 Euros/day/patient) and from the day of the request’s/evaluation’s PAC the patient has already acquired its DRG, so we can consider that the hospital has renounced approximately to 317,400 thousand euros of reimbursements from the Region. Conclusions: Who benefits from the PAC? 1) The patient, who have a lower rate of re-hospitalization; 2) The patient, who have an adequate and protected discharge path 3) the AC, that have more bed available 4) the hospital that has adequate healthcare reimbursement for the provided medical service.
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