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Postacute Care: Reasons for Its Growth and a Proposal for Its Control Through the Early Detection, Treatment, and Prevention of Hospital-Acquired Disability

Published:August 02, 2014DOI:https://doi.org/10.1016/j.apmr.2014.07.397

      Abstract

      Postacute care costs have doubled over the past decade and now account for 17% of Medicare fee-for-service spending. Costs are forecast to continue to rise, paradoxically in large part in response to federal policies and efforts to control health care costs. This commentary introduces a potential solution to this situation and is divided into 4 parts. The first provides a brief review of the policies fostering this growth. The second assesses how the responses of health care providers, while inherently rational, are destructive to the system. The third identifies hospital-acquired disability as a modifiable driver in this scenario, and the fourth discusses how an improvement in detection and a redistribution of hospital-based rehabilitation services may be able to reverse this unsustainable growth.

      Keywords

      List of abbreviations:

      DRG (diagnosis-related group), PAC (postacute care)
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