Abstract

The needs of patients who can stay for extended periods in hospitals generate large amounts of health care expenses. They usually experience multiple diagnoses and their needs are not easily understood or served. This study described the efforts of the acute hospitals in Syracuse, New York to address the needs of these Complex Care patients. The hospitals developed a series of Subacute Programs, each of which addressed a single care need, which might have helped restrain the growth of adult medicine stays during a five-month period. The study demonstrated that reductions in adult medicine stays were associated with the introduction of Complex Care Programs that addressed multiple care needs, in 2015. The association between the implementation of the Complex Care Programs and length of stay reduction for adult medicine was present at the combined and individual hospital levels. The study suggested that the amount of Program Development Funds invested in these programs saved 2000 adult medicine days or $1,600,000 compared with total expenses of $292,000 during a five-month period. The experiences of the Syracuse hospitals suggested that small programs with simple structures could have a positive impact on health care efficiency at the community level.

Highlights

  • In recent years, the importance of efficiency in the movement of patients among health care services has increased

  • The second component of the analysis focused on the impact of the Subacute and Complex Care Programs on lengths of stay for adult medicine patients discharged to nursing homes from the Syracuse hospitals during March-July 2013, 2014, and 2015

  • The third component of the analysis focused on the impact of the Subacute and Complex Care Programs on lengths of stay for adult surgery patients discharged to nursing homes from the Syracuse hospitals during January-June 2013, 2014, and 2015

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Summary

Introduction

The importance of efficiency in the movement of patients among health care services has increased. The need for efficiency has been supported by limitations in resources for major health care payors. (2015) Reducing Hospital Stays through Subacute and Complex Care Programs. Efficiency is important because extended stays in hospitals result in large expenses related to patient care. Limitations in reimbursement from health care payors have not covered the cost of care for outlier patients with multiple diagnoses. The impact of these limitations has been heightened by programs such as Accountable Health Care and Bundling [3]-[5]

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