February 20, 2013

Generating Evidence on Best Practice in Long-term Acute Care Hospitals

Author Affiliations

Author Affiliations: Clinical Research, Investigation and Systems and Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, and Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health (Dr Kahn); and Division of Pulmonary and Critical Care Medicine, University of North Carolina School of Medicine, Chapel Hill (Dr Carson).

JAMA. 2013;309(7):719-720. doi:10.1001/jama.2013.848

Many critically ill patients survive their episode of acute illness but subsequently develop persistent respiratory failure necessitating prolonged mechanical ventilation.1 These patients are often transferred to long-term acute care hospitals (LTACHs)—facilities that specialize in the care of patients with persistent respiratory failure and other complex conditions.2 Driven by an aging population, increased survival following critical illness, and hospital reimbursement models that incentivize early discharge, use of LTACHs has substantially increased in recent years.3 Currently 412 LTACHs are in operation in the United States. These hospitals admit more than 130 000 patients annually and account for more than $5 billion in Medicare expenditures each year.4

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