Aug. 26 (UPI) — Long-term acute care hospitals are supposed to restore independence in people who are have a variety of illnesses, but a new study suggests that for most that isn’t the case.
Fewer than 1-in-5 older adults treated at long-term facilities live beyond five years, according to research published Monday in the Journal of the American Geriatrics Society. And those who do survive often go on to develop cancer or other deadly conditions.
“Understanding the clinical course after long-term acute care hospitals admission can inform goals of care discussions, planning for care at the end of life and prioritizing health care needs,” lead author Anil Makam, a researcher at the University of California at San Francisco and study lead author, said in a news release. “It also may lead some patients to shift from intensive life-sustaining and rehabilitative treatment to hospice care, with a focus on managing their symptoms and improving the quality of their remaining life.”
Researchers analyzed data on more than 14,000 Medicare beneficiaries, 40 percent of whom were treated at long-term acute care hospitals. On average, 45 percent of those patients had one-year survival compared to only 18 percent with five-year survival rates. Meanwhile, about 53 percent never reached 60-day recovery.
The average patient spent 66 percent of their remaining life in hospitals or inpatient facilities, while close to 37 percent died in those settings. In addition, about 16 percent enrolled in hospice for an average of 10 days, a much lower number than most Medicare patients not receiving care in long-term acute care hospitals.
The researchers also found the survival rates of patients between ages 65 and 69 were just over 17 months, and those receiving a musculoskeletal diagnosis were just under 26 months, the highest rates for each respective group.
Conversely, patients older than age 85 lived only 4 months on average, with the average patient spending nearly 98 percent of remaining life in inpatient care. The average patient diagnosed with primary respiratory conditions had a survival rate of just 5.3 months and spent nearly 89 percent of their last months in inpatient care.
One study found people in long-term acute care were at a higher risk for suicide and other mental health needs.
“As we didn’t interview or survey individuals, we don’t know if they desired life-sustaining or intensive care, were informed of their prognosis, received palliative care from their primary physician in the long-term acute care hospitals, or the extent of their symptom burden or quality of life,” Makam said. “But, in many ways, long-term acute care hospitals are a more ideal setting for palliative care interventions than acute care hospitals given their much longer length of stay, higher concentration of very ill patients and less focus on diagnostic evaluation.”