Impact of Long-Term Acute Care Hospital Closures on Patient Care Patterns and Outcomes

A study published in JAMA Network Open examines the impact of long-term acute care hospital closures on care patterns and outcomes for patients requiring mechanical ventilation, revealing changes in discharge patterns and advanced directive decisions without affecting mortality rates.

In the US, patients surviving critical illness may go to short-stay hospitals, skilled nursing facilities, or long-term acute care hospitals for post-acute care. Long-term acute care hospitals offer advanced interdisciplinary care with higher nurse-to-patient ratios, historically receiving higher reimbursement rates until CMS reforms in 2005. Closing many LTCHs due to financial pressures could impact upstream hospital care patterns for patients at risk for prolonged mechanical ventilation.

Data from Medicare files from 2011 to 2019 were used, including demographic and...