Background
Skilled nursing facility (SNF) residents are at increased risk of Clostridioides difficile infection (CDI). The study describes the role of SNFs in CDI transitions of care among hospitalized patients in the United States.
Methods
This was a retrospective cohort study using the PINC AI Healthcare Database. Older adults (65+ years) were included if they had an index, nonrecurrent CDI hospitalization between July 2019 and December 2022. Patient and CDI characteristics, health outcomes (inpatient mortality, hospital length of stay, and readmissions), and hospital costs were compared between patients admitted from or discharged to a SNF.
Results
Among 86,646 index CDI hospitalizations, only 5.1% of CDI patients were admitted from a SNF; however, 28.3% were discharged to a SNF. Patients admitted from SNFs more commonly experienced inpatient mortality (13.5% vs 8.2%), all-cause readmission (31.0% vs 28.0%), higher median hospital costs ($18,610 vs $15,270), and longer median hospital length of stay (8 vs 7 days) (P < .05 for all). Similar trends were noted for patients discharged to a SNF.
Conclusions
Older, hospitalized CDI patients originating from SNFs disproportionately experience poor health outcomes and financial burden. Over one-quarter of CDI patients were discharged to a SNF suggesting a need for higher levels of health care following CDI.
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