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Elderly black patients readmitted to hospital more often than whites

(RxWiki News) Hospital readmission rates for elderly black patients are greater than those of white patients, according to a new study.

Hospital readmissions have become a point of focus for policy makers, as readmissions present an opportunity to improve quality of care at the same time as reducing costs. Although a lot of research has been conducted exploring racial disparities in health care, little is know about the racial disparities in hospital readmission rates.

In order to shed light on this topic, Karen E. Joynt, M.D., M.P.H., from the Harvard School of Public Health and Brigham and Women's Hospital, and colleagues designed a study to see if black patients had a greater chance of readmission than white patients, and if any disparities were related to the quality of care that black patients received.

For this study, the researchers grouped hospitals into two categories: "minority-serving" (the 10 percent of hospitals that serve the most black patients) or "non-minority serving" (the remaining 90 percent of hospitals). Using national Medicare data, the researchers analyzed 30-day readmissions after hospitalization for heart attack, congestive heart failure, and pneumonia. They then calculated the odds of readmission for black patients versus white patients at minority-serving and non-minority-serving hospitals.

Their results showed that black patients discharged from either type of hospital faced a 13 percent greater risk of readmission compared to white patients. Patients discharged from minority-serving hospitals had a 23 percent increased risk of readmission compared to patients discharged from non-minority-serving hospitals. Among patients with acute myocardial infarction (heart attack), those who were black faced a 13 percent greater risk of readmission, regardless of the type of hospital. The researchers also found that patients discharged from minority-serving hospitals faced a 22 percent increased risk of readmission, no matter their race.

Furthermore, white patients at non-minority-serving hospitals had the lowest risk of readmission while black patients at minority-serving hospitals faced the highest risk of readmission.

According to the authors, their findings suggest that readmission rates are associated more with the site of care rather than the race of the patient. Although race appears to be a factor, the site where a patient receives care seems to be at least as important as the patient's race.

Hospital readmission rates are calculated differently by different institutions; readmission is usually counted as admission to the same hospital after 7, 15, or 30 days after discharge from the initial visit. However, most experts agree that regardless of how it's measured, high readmission rates suggest there is room to improve quality of care and to reduce health care costs.

The study is published in JAMA.

Review Date: 
February 16, 2011