Senior Services in US Hospitals and Readmission Risk or Mortality Among Medicare Beneficiaries Since the Affordable Care Act

Alicia I Arbaje; Susannah Woodman; Maningbe B Keita Fakeye; Bruce Leff; Qilu Yu

doi:10.1177/07334648231161925

Senior Services in US Hospitals and Readmission Risk or Mortality Among Medicare Beneficiaries Since the Affordable Care Act

J Appl Gerontol. 2023 Jul;42(7):1424-1432. doi: 10.1177/07334648231161925. Epub 2023 Mar 2.

Authors

Alicia I Arbaje^{1

2

3}, Susannah Woodman⁴, Maningbe B Keita Fakeye^{1

3}, Bruce Leff^{1

3

5}, Qilu Yu⁶

Affiliations

¹ Division of Geriatric Medicine and Gerontology, Department of Medicine, Center for Transformative Geriatrics Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² Center for Health Care Human Factors, Armstrong Institute for Patient Safety and Quality, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA.
³ Department of Health Policy and Management, Johns Hopkins UniversityBloomberg School of Public Health, Baltimore, MD, USA.
⁴ Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Baltimore, MD, USA.
⁵ Department of Community and Public Health, Johns Hopkins School of Nursing, Baltimore, MD, USA.
⁶ Office of Clinical and Regulatory Affairs, National Center for Complementary and Alternative Medicine, Bethesda, MD, USA.

PMID: 36864584
DOI: 10.1177/07334648231161925

Abstract

Background: The Senior Care Services Scale (SCSS) describes hospital provision of older adult services before the passage of the Affordable Care Act. Objectives: Since act passage, (1) update SCSS service groups; and (2) investigate hospital SCSS scores' relationship to readmission or mortality among Medicare beneficiaries. Methods: Retrospective cohort analysis of older adults ≥65 years (n = 1,416,669), admitted to 2570 US acute-care hospitals from 2014 to 2015. Outcomes: Hospital readmission, or death, within 30 and 90 days of discharge. Results: The updated SCSS had three service groups: Inpatient Specialty Care, Post-Acute Community Care, and Home Care and Hospice. Older adults admitted to high Inpatient-Specialty-Care-scoring hospitals had lower risk of death within 30 days (RR .94, 95% CI .91-.98), and 90 days (RR .94, 95% CI .91-.97). There was no significant association between Home-Care-and-Hospice and Post-Acute-Community-Care scores and study outcomes. Conclusion: Greater provision of hospital-level senior services may be associated with mortality reduction among Medicare beneficiaries.

Keywords: American hospital association; Medicare; aged; health services for the aged; patient readmission.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Aged
Hospitals
Humans
Medicare
Patient Discharge
Patient Protection and Affordable Care Act*
Patient Readmission*
Retrospective Studies
United States

Grants and funding

K08 HS022916/HS/AHRQ HHS/United States