Racial/ethnic disparities in potentially preventable readmissions: the case of diabetes.

OBJECTIVES: Considerable differences in prevalence of diabetes and management of the disease exist among racial/ethnic groups. We examined the relationship between race/ethnicity and hospital readmissions for diabetes-related conditions. METHODS: Nonmaternal adult patients with Medicare, Medicaid, o...

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Publicado en:American Journal of Public Health Vol. 95; no. 9; pp. 1561 - 1568
Autores principales: Jiang HJ, Andrews R, Stryer D, Friedman B
Formato: research tables/charts Journal Article
Publicado: American Public Health Association Sep2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2005
      vid: 95
      iid: 9
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      pub: American Public Health Association
      place: Washington, District of Columbia
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        atl: Racial/ethnic disparities in potentially preventable readmissions: the case of diabetes.
      aug:
        au:
          Jiang HJ
          Andrews R
          Stryer D
          Friedman B
        affil: Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, 540 Gaither Rd, Rockville, MD 20850; jjiang@ahrq.gov
      sug:
        subj:
          Diabetes Mellitus Complications
          Diabetes Mellitus Prevention and Control
          Disease Management
          Race Factors
          Readmission Evaluation
          Adult
          After Care
          Age Factors
          Aged
          Black Persons
          California
          Chi Square Test
          Cross Sectional Studies
          Demography
          Health Care Costs
          Health Resource Utilization
          Health Services Research
          Hispanic Americans
          Hospitals
          Inpatients
          Insurance, Health
          International Classification of Diseases
          Logistic Regression
          Medicaid
          Medicare
          Middle Age
          Missouri
          New York
          P-Value
          Record Review
          Resource Databases, Health
          Socioeconomic Factors
          Tennessee
          Time Factors
          Vascular Diseases
          Virginia
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
      ab: OBJECTIVES: Considerable differences in prevalence of diabetes and management of the disease exist among racial/ethnic groups. We examined the relationship between race/ethnicity and hospital readmissions for diabetes-related conditions. METHODS: Nonmaternal adult patients with Medicare, Medicaid, or private insurance coverage hospitalized for diabetes-related conditions in 5 states were identified from the 1999 State Inpatient Databases of the Healthcare Cost and Utilization Project. Racial/ethnic differences in the likelihood of readmission were estimated by logistic regression with adjustment for patient demographic, clinical, and socioeconomic characteristics and hospital attributes. RESULTS: The risk-adjusted likelihood of 180-day readmission was significantly lower for non-Hispanic Whites than for Hispanics across all 3 payers or for non-Hispanic Blacks among Medicare enrollees. Within each payer, Hispanics from low-income communities had the highest risk of readmission. Among Medicare beneficiaries, Blacks and Hispanics had higher percentages of readmission for acute complications and microvascular disease, while Whites had higher percentages of readmission for macrovascular conditions. CONCLUSIONS: Racial/ethnic disparities are more evident in 180-day than in 30-day readmission rates, and greatest among the Medicare population. Readmission diagnoses vary by race/ethnicity, with Blacks and Hispanics at higher risk for those complications more likely preventable with effective postdischarge care.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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