Racial Disparities in Readmission Rates among Patients Discharged to Skilled Nursing Facilities.
Black or African American
/ statistics & numerical data
Aged
Aged, 80 and over
Fee-for-Service Plans
/ statistics & numerical data
Female
Healthcare Disparities
/ ethnology
Hispanic or Latino
/ statistics & numerical data
Humans
Male
Medicare Part C
/ statistics & numerical data
Patient Readmission
/ statistics & numerical data
Racial Groups
/ statistics & numerical data
Skilled Nursing Facilities
/ statistics & numerical data
United States
White People
/ statistics & numerical data
Medicare Advantage
disadvantaged populations in skilled nursing facilities
disparities in 30-day readmission rates
disparities in readmissions among Medicare Advantage and fee-for-service patients
readmissions in skilled nursing facilities
Journal
Journal of the American Geriatrics Society
ISSN: 1532-5415
Titre abrégé: J Am Geriatr Soc
Pays: United States
ID NLM: 7503062
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
23
01
2019
revised:
02
04
2019
accepted:
03
04
2019
pubmed:
9
5
2019
medline:
26
5
2020
entrez:
9
5
2019
Statut:
ppublish
Résumé
Prior studies have reported mixed findings about the existence of racial disparities in readmission rates among Medicare Advantage beneficiaries, but these studies used data from one state, focused on black-white disparities, and did not focus on patients discharged to skilled nursing facilities (SNFs). The objective of the study was to characterize racial and ethnic disparities in rates of 30-day rehospitalization directly from SNFs among fee-for-service and Medicare Advantage patients. A cross-sectional study of admissions to SNFs in 2015 was conducted. SNFs across the United States. The sample included 1 500 334 white, 213 848 African American, and 99 781 Hispanic Medicare patients who were admitted to 13 375 SNFs. The main outcome of interest was readmission, identified as patients sent back to any hospital directly from the SNF within 30 days of admission, as indicated on the Minimum Data Set discharge assessment. Overall readmission rates for fee-for-service patients were 16.7% (95% confidence interval [CI] = 16.7%-16.8%) for whites, 18.8% (95% CI = 18.7%-19.0%) for African Americans, and 17.4% (95% CI = 17.1%-17.7%) for Hispanics. Readmission rates in Medicare Advantage were 14.7% (95% CI = 14.5%-14.8%) for whites, 16.8% (95% CI = 16.6%-17.1%) for African Americans, and 15.3% (95% CI = 14.9%-15.6%) for Hispanics. We also found that African Americans had about 1% higher readmission rates than whites, even when they received care within the same SNF. No statistically significant differences were found in the magnitude of within-SNF racial disparities in Medicare Advantage compared with Medicare fee-for-service. We found racial disparities in readmission rates even within the same facility for both Medicare Advantage and fee-for-service beneficiaries. Intervention to reduce disparities in readmission rates, as well as more comprehensive quality measures that incorporate outcomes for Medicare Advantage enrollees, are needed. J Am Geriatr Soc 67:1672-1679, 2019.
Identifiants
pubmed: 31066913
doi: 10.1111/jgs.15960
pmc: PMC6684399
mid: NIHMS1025633
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1672-1679Subventions
Organisme : NIA NIH HHS
ID : P01 AG027296
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54 GM115677
Pays : United States
Organisme : NIGMS NIH HHS
ID : U54GM115677
Pays : United States
Organisme : NIA NIH HHS
ID : P01AG027296-07S1
Pays : United States
Informations de copyright
© 2019 The American Geriatrics Society.
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