Because medical needs of long term care patients are often being neglected when they transition from a long term stay in a nursing home to a home and community based services program, they are at a greater risk of hospitalization than those with similar conditions who choose to stay in a nursing home.
A recent study published in the Journal of the American Geriatrics Society (J Am Geriatr Soc 62:71–78, 2014.) and led by Andrea Wysocki, PhD, Center for Gerontology and Healthcare Research, Brown University, Providence, Rhode Island compares hospitalizations of dually eligible older adults who had an extended Medicaid nursing home (NH) stay and transitioned out to receive Medicaid home- and community-based services (HCBS) with hospitalizations of those who remained in the nursing home.
Home and Community based services programs for patients with long term care (LTC) needs have been very in demand recently not only because patients prefer to be in a home and community setting rather than in an institutional setting but also because the per-person costs are usually lower for HCBS than for nursing homes.
However according to the study older adults with long term care needs usually have complex medical conditions that may be neglected by HCBS programs. The transition from continuous care in a nursing home to a fragmented healthcare system in the community put LTC patients at a higher risk of hospitalization because they often do not receive the timely medical care required by their condition.
The study matched 1169 patients who decided to stay in a nursing home with 1169 patients with similar conditions who decided to transition to a HCBS during a period of two years. During this time 297 “stayers” were hospitalized with 113 potentially preventable hospitalizations and 419 transitioners were hospitalized with 133 potentially preventable hospitalizations.