A new study measuring the prevalence of care integration between hospitals and skilled nursing facilities (SNFs) found that most of those integrations are informal.
The study looks at several types of care integration based on the relationships between the SNFs and hospitals and indicates that meetings between hospital and SNF leadership are the most common form of care integration for SNF-hospital pairs, followed by shared clinicians and care coordinators.
It was conducted by researchers with Netherlands-based Elsevier, a publishing company specializing in scientific, technical and medical content.
The study identified key organizational and inter-organizational characteristics associated with care integration between SNFs and hospitals, using a nationwide survey to capture that information.
It comes as post-acute care transitions — and the difficulties older adults experience while going through them — are receiving more national attention.
The study found that care integration practices between SNFs and hospitals vary greatly.
In the past, other studies have suggested that the main effect of hospital-SNF relationships is a decrease in SNF use overall.
Meanwhile, the Elsevier study indicates that hospital and SNF leadership and culture play an important role in stimulating efforts to improve care integration.
How the study was conducted
For the study, researchers sent a survey to 500 randomly selected Medicare-certified SNFs in the U.S. in 2019. It asked about 12 care integration activities and whether each SNF partook in them with either of their two highest volume referring hospitals.
Care integration activities were surveyed and measured using questions regarding shared care coordinators, shared supervising clinicians, meetings between clinical leadership and processes that reduced hospital visits.
Hospital-SNF pairs were less likely to be formally integrated if the SNF was for-profit, but more likely to share quality improvement activities if located in metropolitan areas or in the Midwest.
A total of 265 SNFs responded to the survey, with 487 SNF-hospital pairs identified.
Of the 12 individual integration activities assessed, meetings between hospital and SNF leadership were the most common.
“Efforts to understand how to most successfully grow hospital and SNF relationships and engage in effective care integration activities are urgent as the U.S. population ages and post-acute care use increases,” the researchers concluded.
