The rate of questionable transfers of end-stage dementia patients from nursing homes to hospitals has raised flags for public health researchers at Brown University.
After analyzing Medicare records of approximately 475,000 patients, the team, led by Dr. Joan Teno, M.D., found that nearly 20 percent of dementia patients were transferred from their nursing homes into hospitals for questionable reasons.
Typically, long-term care facilities will move advanced dementia patients to hospitals when they develop pneumonia, problems with swallowing, or infections. The researchers suspect that in many cases, money and Medicare reimbursements are playing a role for earlier transfers.
Medicare pays more than $500 per day when residents with dementia are transferred back to a nursing home after a hospitalization lasting three days or more.
Burdensome and potentially life-threatening for the transferred patients, the hospital stays hasten the depletion of Medicare-reimbursed care. Despite this, the data set shows no evidence of wrongdoing in the nursing homes or hospitals.
Researchers observed a wide range in the rate of transfers from state to state.
The study was published on September 29 in the New England Journal of Medicine.