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