In this large retrospective observational cohort of CHF medicare patients, from 1993 to 2006, there were substantial decreases in mean LOS (from 8.8 to 6.3 day) and in-hospital mortality (9% to 4%). However, there were substantial increases in the percentage of patients discharged to skilled nursing facilities (13% to 20%) and the percentage of patients readmitted within 30 days (17% to 20%). These increases are likely reflecting CHF patients living longer and living sicker. However, new Medicare incentives to reduce readmission rates may push the pendulum back to longer LOS (abstract).
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