Table 3. Differences in Outcome for Discharge to Home Health Care vs Skilled Nursing Facility.
| Outcome | Multivariable Regression | Instrumental Variable Regression | ||
|---|---|---|---|---|
| Difference (95% CI) | P Value | Difference (95% CI) | P Value | |
| Patient outcomes (all discharges [N = 17 235 854]), percentage points | ||||
| Readmission within 30 d | −1.6 (−1.7 to −1.6) | <.001 | 5.6 (0.8 to 10.3) | .02 |
| Death within 30 d | −4.0 (−4.0 to −3.9) | <.001 | −2.0 (−4.5 to 0.5) | .12 |
| Improvement in activities of daily livinga | 57.1 (56.6 to 57.5) | <.001 | −1.9 (−12.0 to 8.2) | .71 |
| Medicare payment (fee-for-service Medicare discharges [n = 13 000 109]), $ | ||||
| Medicare payment to hospital | −698 (−740 to −655) | <.001 | −1766 (−3621 to 89) | .06 |
| Medicare payment to HHA or SNF | −8145 (−8244 to −8045) | <.001 | −5384 (−6932 to −3837) | <.001 |
| Total Medicare payment in first 60 d after hospital admission | −9195 (−9309 to −9081) | <.001 | −4514 (−7150 to −1879) | <.001 |
Abbreviations: HHA, home health agency; SNF, skilled nursing facility.
a
A total of 10 315 669 discharges for the outcome of improvement in activities of daily living because of missing assessments at discharge from postacute care for some patients.