This large retrospective cohort of medicare beneficiaries >age 65 found that utilization of LTACs (long term acute care hospitals) after a critical illness increased from 39 to 100 (per 100,000) from 1997 to 2006 (and the number of LTAC facilities increased 9% per year). Annual cost of this care increased from $484 million to $1.325 billion. The 1 year mortality was relatively unchanged throughout the study period, ranging 51-52%. LTAC utilization and cost has dramatically increased in elderly patients post critical illness, and these patients have >50% mortality at 1 year. These patients have a poor prognosis and should be identified and treated as such (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.