Structure, process, and outcomes in skilled nursing facilities: understanding what happens to surgical patients when they cannot go home. A systematic review

Abstract Background The surgical population is aging, and greater numbers of surgical patients are being discharged to skilled nursing facilities. Post-acute care is a poorly understood but very important aspect of our healthcare system. Methods This systematic review examines the current body of li...

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Bibliographic Details
Published in:The Journal of surgical research 2015-02, Vol.193 (2), p.772-780
Main Authors: Hakkarainen, Timo W., MD, MS, Ayoung-Chee, Patricia, MD, MPH, Alfonso, Rafael, MD, PhD, Arbabi, Saman, MD, MPH, FACS, Flum, David R., MD, MPH, FACS
Format: Article
Language:English
Subjects:
Humans
Outcome and Process Assessment (Health Care)
Skilled Nursing Facilities
Surgery
Surgical Procedures, Operative - mortality
Surgical Procedures, Operative - rehabilitation
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Summary:Abstract Background The surgical population is aging, and greater numbers of surgical patients are being discharged to skilled nursing facilities. Post-acute care is a poorly understood but very important aspect of our healthcare system. Methods This systematic review examines the current body of literature surrounding the structural, process of care, and outcomes measurements for patients in skilled nursing facilities. English language articles published between 1998 and 2011 that purposed to examine nursing facility structure, process of care, and/or outcomes were included. Results & Conclusions Abstracts (2129) were screened and 102 articles were reviewed in full. Twenty-nine articles were included in the qualitative synthesis. The role of the care setting and care delivery in contributing to outcomes has not been well studied, and no strong conclusions can be made. This area of care currently represents a “black box” to practicing surgeons. An understanding of these factors maybe instrumental to determining future directions for research to maximize positive outcomes for these patients.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2014.06.002