Difficult Decisions About Post-Acute Care

Each year, approximately 1 in 5 hospital patients in the United States, including some 300,000 New Yorkers, require continued care following hospital stays for major surgery or serious illness.

Yet too often, patients and their families do not have the critical information and support they need to carefully assess their options and make the best possible decisions.

Two new reports by the United Hospital Fund (UHF), supported by NYHealth, are the next installments in UHF’s four-part “Difficult Decisions” series, based on a yearlong inquiry to better understand why hospital discharge planning can fall short despite well-intentioned efforts by hospital staff. The new reports highlight the challenges faced by patients and family caregivers during the transition to post-hospital care, along with health provider perspectives on discharge planning.

“The Illusion of Choice: Why Decisions About Post-Acute Care Are Difficult for Patients and Family Caregivers” relates the experiences of patients and their family caregivers being discharged from a hospital and spotlights the barriers to informed decision-making. Findings reveal that patients and their families felt rushed, uninvolved, and provided with insufficient information when choosing a post-acute care facility.

“Health Care Provider Perspectives on Discharge Planning: From Hospital to Skilled Nursing Facility” provides insight on the challenges health care providers face when helping patients transition to post-acute care, highlighting discussions with administrators and frontline staff at eight hospitals in the New York State. The report finds that staff members’ efforts are frustrated by inefficiency pressures, insurance constraints, authorization delays, and regulations that limit the support they can provide to patients and family caregivers.

UHF published the first report in this series, “Difficult Decisions About Post-Acute Care and Why They Matter,” in November 2018. These reports combine UHF’s research with input from patients and their families, health care providers, researchers, policymakers, and other stakeholders to identify promising approaches for supporting decision-making at discharge. The “Difficult Decisions” series by UHF takes a broad look at the many factors, including regulation, that make informed decision-making about post-acute care so challenging.