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Keehan, S.P., Cuckler, G.A., Sisko, A.M., Madison, A.J., Smith, S.D., Stone, D.A., Poisal, J.A., Wolfe, C.J. and Lizonitz JM. (2015) National Health Expenditure Projections, 2014-2024: Spending Growth Faster than Recent Trends. Health Affairs, 34, 1407-1417.

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• TITLE: Development of Subacute and Complex Care Programs at the Community Level

  AUTHORS: Ronald Lagoe, Cheryl Noetscher, Shelly Littau

  KEYWORDS: Hospital Lengths of Stay, Hospitalization, Long Term Care

  JOURNAL NAME: Open Journal of Nursing, Vol.6 No.11, November 24, 2016

  ABSTRACT: Patients requiring Subacute and Complex Care services continue to challenge hospitals attempting to reduce inpatient stays and improve efficiency. In recent years, numbers of high severity of illness patients in hospitals have increased, adding to this challenge. Nurse care managers have a major responsibility for supporting the care of these patients. This study described the development of services for Subacute and Complex Care patients in the hospitals of Syracuse, New York. These hospitals used their own resources to develop programs including high cost medications, intravenous therapy, extensive wound care, and bariatric care in settings where they had not been available. In the absence of third party funding of another level of care, the hospitals provided program development funds for limited time periods in order to initiate these services. The Syracuse hospitals were able to phase out support for these programs after they were operational in the nursing homes for an extended period of time. The study data indicated that implementation of these programs limited the rate of increase of adult medicine stays and reduced adult surgery stays. The severity of illness for both major services increased in the Syracuse hospitals during this time. This process required acute and long term care providers who were interested in making the process work for the benefit of the patient populations involved, as well as for the needs of their own organizations.