Navigating Postacute Care Pathways Following Hospital Discharge in Plastic Surgery

Discharge destination following hospitalization plays a critical role in surgical recovery, long-term outcomes, and healthcare resource use. Although postacute care facilities are increasingly used, there is limited literature within plastic surgery addressing their role and implications. This review outlined the continuum of discharge options available to plastic surgery patients, including long-term acute care hospitals, inpatient rehabilitation facilities, skilled nursing facilities, assisted living facilities, postoperative guest suites, and home with or without home health care. Each destination differs significantly in patient acuity, level of available services, and payer coverage. Plastic surgery patients undergoing complex procedures such as free tissue transfer, trauma reconstruction, or burn care may require specialized facilities for wound management, rehabilitation, or close monitoring. Medicare and Medicaid policies influence access, and coverage varies widely across facility types and states. Home discharge is generally associated with superior outcomes and more predictable costs, but nonhome postacute care facilities remain essential for patients with higher medical and functional needs. For plastic surgeons, knowledge of these discharge settings is essential to effective discharge planning, directly impacting readmission rates, reimbursement, and patient recovery. Plastic surgeons must engage actively in discharge planning by advocating for the most appropriate level of care, aligning patient safety, functional recovery, and financial stewardship.