Hospital Readmission Following Care in a Swing Bed

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About this project

Lead researcher: Mark Holmes, PhD
Project funded: September 2012
Project completed: July 2021

Preventable hospital readmissions are a significant problem for patients and insurers. Swing beds are the only post-acute care in many very rural communities but research on the ability of swing bed care to prevent readmission is limited. A better understanding of the outcome of treatment in swing beds is needed to inform Medicare payment policy as well as demonstration and other projects to decrease preventable readmissions.

Study questions include:

1. Are patients discharged to swing beds readmitted at the same rate as patients discharged to skilled nursing facilities;
2. Do readmission rates differ for patients discharged to swing beds from different hospital types, e.g. CAH or PPS;
3. Do readmission rates from swing beds differ by diagnoses most often associated with preventable readmission; and
4. Do readmission rates from swing beds vary by patient characteristics, e.g., age and gender, or by clinical course such as length of stay, surgical procedure, or complications?

The study used Research Identifiable Files for Medicare reimbursed services and included all Medicare-covered acute care hospital stays. Rates of readmission in the 30 days following discharge to post-acute care were calculated for patients discharged to swing beds and to SNF care comparing all patients and subsets of patients.

The chi-square test was used to test for significant differences in readmission rates, which were further explored adjusting for risk of readmission. Comparison between groups, e.g., swing bed versus SNF, CAH patients versus PPS, etc., informed the debate about the costs and benefits of swing beds.