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Blacks Readmitted to Hospital More Than Whites: Study
Date:2/15/2011

By Serena Gordon
HealthDay Reporter

TUESDAY, Feb. 15 (HealthDay News) -- After leaving the hospital for treatment of three common conditions, older black people are more likely to be readmitted within 30 days than older white people, a new study finds.

Overall, older blacks have 13 percent greater odds of being readmitted to the hospital, recent research suggests, while patients treated at hospitals that primarily serve minority populations have 23 percent greater odds of readmission within 30 days.

"There are significant racial disparities in readmission rates in this country," said the study's lead author, Dr. Karen Joynt, a health policy fellow at the Harvard School of Public Health in Boston.

"We found that both race and site of care mattered. The next step is to find out why this disparity exists," she said.

And, she noted, no matter what the race, about 20 percent of people discharged from the hospital are readmitted within 30 days, which suggests that there are gaps in care that need to be identified and addressed.

"Hospital discharge is a really vulnerable time. Going home from the hospital often requires medication changes, diet changes and lifestyle changes. Even in the best case scenario, one in five is being readmitted," she said.

Because readmissions are so common, reducing the rate of readmission is a focus in health-care policy. Previous studies have suggested that racial disparities may play a role in readmission rates, but the evidence was inconclusive, according to background information in Joynt's study.

Using national Medicare data that included more than 3 million hospital discharges for heart attack, congestive heart failure and pneumonia, the researchers compared the rate of readmissions for blacks and for whites. To conform with other research, the researchers considered any non-black patients as white, which means that Hispanics, Asians and Native Americans were placed in the white category for this study.

The researchers also looked at the data by hospital, and whether or not a hospital was primarily a minority-serving hospital.

Of the 3 million plus discharges, 276,681 (8.7 percent) were for black patients, and 2,886,330 (91.3 percent) were for white patients. About 40 percent of the black patients and 6 percent of white patients received care at hospitals that primarily served minorities.

The average age of the patients was mid-70s to early 80s, depending on the condition. There were slightly more women included in this study than men.

Overall, readmission rates were 24.8 percent for blacks and 22.6 percent for whites, which means black patients have 13 percent greater odds of readmission within 30 days after discharge, according to the study.

Among those who had been admitted for heart attack, black patients from minority-serving hospitals had the highest readmission rates -- 26.4 percent, according to the study. That translated to 35 percent greater odds of readmission for this group.

The results of the study are published in the Feb. 16 issue of the Journal of the American Medical Association.

Joynt said this study wasn't able to tease out the reasons that these disparities exist, but said that less access to transitional care may play a role. She said that other research has shown that good follow-up care after a hospital discharge can make a difference in readmission rates.

"The biggest take-away from this study is that currently, hospital readmission is a major problem in the U.S., and we need better solutions to help prevent readmission," said the co-author of an editorial in the same issue of the journal, Dr. Adrian Hernandez, an associate professor of medicine at Duke University School of Medicine in Durham, N.C.

"This was an excellent study that raises important questions. How can we get a process in place that strengthens the support received after discharge? How do we get resources that will enable hospitals to reach beyond their doors to provide services and support to vulnerable populations?" he said.

More information

For advice on how to prepare for a hospital discharge and care at home, visit the Family Caregiver Alliance Web site.

SOURCES: Karen Joynt, M.D., M.P.H., health policy fellow, Harvard School of Public Health, and cardiology fellow, Brigham and Women's Hospital, Boston; Adrian Hernandez, M.D., M.H.S., associate professor, medicine, Duke University School of Medicine, Durham, N.C.; Feb. 16, 2011, Journal of the American Medical Association


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