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Frail patients who are discharged from the hospital have an increased risk of readmission or death within 30 days compared with patients who are not considered frail. This is a long established fact and much research and literature is available on the topic. A Google search will provide you with ample support for this fact.

There is also even more information, both scientific and in social media, on the poor care people receive in nursing homes and on the inevitable increased risk for all bad outcomes for the most frail being cared for in nursing facilities. (As an antidote to the negative reporting please read some of the Patient Pattern “Nursing Home News” blogs.)

So it was good news to read an article published recently in the Journal of the American Geriatrics Society that opened with this finding: “Hospital patients discharged to homes or home healthcare settings are 38% more likely to return with a linked infection than those discharged to skilled nursing facilities, a University of Michigan study has found.”

Role of Post‐Acute Care in Readmissions for Preexisting Healthcare‐Associated Infections by Geoffrey J. Hoffman PhD et al. First published: 23 October 2019  https://doi.org/10.1111/jgs.16208

The investigation commented on possible reasons for these findings and noted that the nursing home is an environment where frail patients easily succumb to infections BUT where professionals know how to treat those infections thus avoiding a readmission. “The most common infection found to be linked with hospital readmission was Clostridioides difficile (roughly 5% readmission), followed by urinary tract infections (2.4% readmission)”. Certainly good nursing home care and competent medical providers can manage these diagnoses in-house and according to this data are doing so. Kudos to good nursing home care and a reminder to our home-care colleagues that post-hospital home care may need to consider the degree of frailty present in their clients and be proactive in preventing a readmission where possible.