Selecting post-acute care settings after abdominal surgery: Are we getting it right?

Courtney J. Balentine, Glen Leverson, David J. Vanness, Sara Knight, Janet Turan, Cynthia J. Brown, Herb Chen, Smita Bhatia

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: We investigated whether variation in post-acute care (PAC) services could be explained by surgeons discharging clinically similar patients to different PAC destinations, including home health (HH), skilled nursing facilities (SNF), and inpatient rehabilitation (IR). Methods: We studied patients having colectomy, pancreatectomy or hepatectomy in the 2008–2011 Nationwide Inpatient Sample. We used propensity matching to determine: 1. Proportion of patients discharged to SNF/IR who could be matched to clinically similar patients discharged with HH. 2. Potential cost savings from greater use of HH. Results: 30,843 patients were discharged with HH and 23,172 to SNF or IR. 14,163 (61%) SNF/IR patients could be matched to similar patients discharged with HH. Potential cost savings from increasing use of HH as an alternative to SNF/IR ranged from $2.5-$438 million annually. Conclusions: There is considerable potential for reducing variation in PAC use and costs by better understanding how surgeons make decisions about PAC placement.

Original languageEnglish (US)
Pages (from-to)260-266
Number of pages7
JournalAmerican Journal of Surgery
Issue number2
StatePublished - Aug 2018

All Science Journal Classification (ASJC) codes

  • Surgery


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