Does race affect readmission to hospital after critical illness?

Epstein, Carol Diane; Tsaras, Geoffrey; Amoateng-Adjepong, Yaw; Greiner, P; Manthous, Constantine A.

doi:10.1016/j.hrtlng.2008.01.001

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…10,12 , 14,15 Several studies have suggested that better coordination of care and communication between acute and PAC providers may have the most potential to reduce readmission rates. 6,16-19…”

Section: Introductionmentioning

confidence: 99%

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Gupta

Zengul

Davlyatov

et al. 2019

INQUIRY

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Hospital readmission within 30 days of discharge is an important quality measure given that it represents a potentially preventable adverse outcome. Approximately, 20% of Medicare beneficiaries are readmitted within 30 days of discharge. Many strategies such as the hospital readmission reduction program have been proposed and implemented to reduce readmission rates. Prior research has shown that coordination of care could play a significant role in lowering readmissions. Although having a hospital-based skilled nursing facility (HBSNF) in a hospital could help in improving care for patients needing short-term skilled nursing or rehabilitation services, little is known about HBSNFs’ association with hospitals’ readmission rates. This study seeks to examine the association between HBSNFs and hospitals’ readmission rates. Data sources included 2007-2012 American Hospital Association Annual Survey, Area Health Resources Files, the Centers for Medicare and Medicaid Services (CMS) Medicare cost reports, and CMS Hospital Compare. The dependent variables were 30-day risk-adjusted readmission rates for acute myocardial infarction (AMI), congestive heart failure, and pneumonia. The independent variable was the presence of HBSNF in a hospital (1 = yes, 0 = no). Control variables included organizational and market factors that could affect hospitals’ readmission rates. Data were analyzed using generalized estimating equation (GEE) models with state and year fixed effects and standard errors corrected for clustering of hospitals over time. Propensity score weights were used to control for potential selection bias of hospitals having a skilled nursing facility (SNF). GEE models showed that the presence of HBSNFs was associated with lower readmission rates for AMI and pneumonia. Moreover, higher SNFs to hospitals ratio in the county were associated with lower readmission rates. These findings can inform policy makers and hospital administrators in evaluating HBSNFs as a potential strategy to lower hospitals’ readmission rates.

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Section: Introductionmentioning

confidence: 99%

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Gupta

Zengul

Davlyatov

et al. 2019

INQUIRY

View full text Add to dashboard Cite

show abstract

“…Insurance status was included in our study, and Medicaid may serve as a rough proxy for lower socioeconomic status. However, the intersection of race, income, and insurance status is well documented and would be an important focus in future studies [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Racial Disparities in 7-Day Readmissions from an Adult Hospital Medicine Service

Rambachan

Abe-Jones

Fernández

et al. 2021

J. Racial and Ethnic Health Disparities

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Background Health systems have targeted hospital readmissions to promote health equity as there may be racial and ethnic disparities across different patient groups. However, 7-day readmissions have been understudied in adult hospital medicine. Design This is a retrospective study. We performed multivariable logistic regression between patient race/ethnicity and 7-day readmission. Mediation analysis was performed for limited English proficiency (LEP) status. Subgroup analyses were performed for patients with initial admissions for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and cancer. Patients We identified all adults discharged from the adult hospital medicine service at UCSF Medical Center between July 2016 and June 2019. Main Measures The primary outcome was 7-day all-cause readmission back to the discharging hospital. Results There were 18,808 patients in our dataset who were discharged between July 2016 and June 2019. A total of 1,297 (6.9%) patients were readmitted within 7 days. Following multivariable regression, patients who identified as Black (OR 1.35, 95% CI 1.15–1.58, p <0.001) and patients who identified as Asian (OR 1.26, 95% CI 1.06–1.50, p = 0.008) had higher odds of readmission compared to white patients. Multivariable regression at the subgroup level for CHF, COPD, and cancer readmissions did not demonstrate significant differences between the racial and ethnic groups. Conclusions Black patients and Asian patients experienced higher rates of 7-day readmission than patients who identified as white, confirmed on adjusted analysis.

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“…First, some studies have eluded to early readmissions resulting from poor coordination of care and lack of identification of patient needs. 11,13,14 Additionally, patients who are typically less sick are perhaps more likely to be discharged earlier. Patients with chronic disease and multiple impairments are likely to have greater durations of hospital stays; complications in these patients would likely arise while they were still hospitalized as opposed to discharged patients who need to be readmitted for treatment.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 Medical literature demonstrates that patients readmitted within a few days of discharge return for different reasons than patients who are readmitted later 11 ; very early readmissions are likely due to poor coordination of care or inadequate recognition of postdischarge needs, while later readmissions (still within the 30-day window) are more likely due to patient disease or procedural complications. 13,14 This study aimed to evaluate reasons for 30-day readmission after VHR. We explored readmission patterns and times to determine if differences exist in etiology of early versus late readmission after VHR.…”

mentioning

confidence: 99%

Causes of readmission after laparoscopic and open ventral hernia repair: Identifying failed discharges and opportunities for action

Celio

Kasten

Pofahl

et al. 2016

Surgery

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Does race affect readmission to hospital after critical illness?

Cited by 7 publications

References 21 publications

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Reduction in Hospitals’ Readmission Rates: Role of Hospital-Based Skilled Nursing Facilities

Racial Disparities in 7-Day Readmissions from an Adult Hospital Medicine Service

Causes of readmission after laparoscopic and open ventral hernia repair: Identifying failed discharges and opportunities for action

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