Are We Asking the Right Question About Postacute Settings of Care?

作者：DeJong Gerben^*

来源：Archives of Physical Medicine and Rehabilitation, 2014, 95(2): 218-221.

DOI：10.1016/j.apmr.2013.10.014

• Recovery of function
• Rehabilitation
• Skilled nursing facilities
• Treatment outcome

This issue of Archives includes an article by Mallinson et al that compares the outcomes of patients with hip fracture who received rehabilitation services in 3 different postacute settings: skilled nursing facilities, inpatient rehabilitation facilities, or home health. Except in 1 instance, Mallinson found no setting-specific effects and noted that the issue of defining an optimum postacute rehabilitation program is complex and requires more investigation. Mallinson's findings are interesting in their own right but raise a more fundamental issue. This commentary observes that rehabilitation patients typically use multiple postacute settings, not just 1 setting of care, for the same episode of care. This commentary asks whether we should be examining episode outcomes and not just setting-specific outcomes, especially in the face of bundled payment and value-based payment reforms in the Affordable Care Act.

• 出版日期2014-2