Senior Services in US Hospitals and Readmission Risk or Mortality Among Medicare Beneficiaries Since the Affordable Care Act

J Appl Gerontol. 2023 Jul;42(7):1424-1432. doi: 10.1177/07334648231161925. Epub 2023 Mar 2.


Background: The Senior Care Services Scale (SCSS) describes hospital provision of older adult services before the passage of the Affordable Care Act. Objectives: Since act passage, (1) update SCSS service groups; and (2) investigate hospital SCSS scores' relationship to readmission or mortality among Medicare beneficiaries. Methods: Retrospective cohort analysis of older adults ≥65 years (n = 1,416,669), admitted to 2570 US acute-care hospitals from 2014 to 2015. Outcomes: Hospital readmission, or death, within 30 and 90 days of discharge. Results: The updated SCSS had three service groups: Inpatient Specialty Care, Post-Acute Community Care, and Home Care and Hospice. Older adults admitted to high Inpatient-Specialty-Care-scoring hospitals had lower risk of death within 30 days (RR .94, 95% CI .91-.98), and 90 days (RR .94, 95% CI .91-.97). There was no significant association between Home-Care-and-Hospice and Post-Acute-Community-Care scores and study outcomes. Conclusion: Greater provision of hospital-level senior services may be associated with mortality reduction among Medicare beneficiaries.

Keywords: American hospital association; Medicare; aged; health services for the aged; patient readmission.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Hospitals
  • Humans
  • Medicare
  • Patient Discharge
  • Patient Protection and Affordable Care Act*
  • Patient Readmission*
  • Retrospective Studies
  • United States