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

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  • Jiang, H.J.
  • Andrews, R.
  • Stryer, D.
  • Friedman, B.

Abstract

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.

Suggested Citation

  • Jiang, H.J. & Andrews, R. & Stryer, D. & Friedman, B., 2005. "Racial/ethnic disparities in potentially preventable readmissions: The case of diabetes," American Journal of Public Health, American Public Health Association, vol. 95(9), pages 1561-1567.
  • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2004.044222_4
    DOI: 10.2105/AJPH.2004.044222
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    Cited by:

    1. Jamie M. Smith & Haiqun Lin & Charlotte Thomas-Hawkins & Jennifer Tsui & Olga F. Jarrín, 2021. "Timing of Home Health Care Initiation and 30-Day Rehospitalizations among Medicare Beneficiaries with Diabetes by Race and Ethnicity," IJERPH, MDPI, vol. 18(11), pages 1-13, May.
    2. Caroline King & Sidney Atwood & Mia Lozada & Adrianne Katrina Nelson & Chris Brown & Samantha Sabo & Cameron Curley & Olivia Muskett & Endel John Orav & Sonya Shin, 2018. "Identifying risk factors for 30-day readmission events among American Indian patients with diabetes in the Four Corners region of the southwest from 2009 to 2016," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-10, August.
    3. Jamie M. Smith & Olga F. Jarrín & Haiqun Lin & Jennifer Tsui & Tina Dharamdasani & Charlotte Thomas-Hawkins, 2021. "Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes," IJERPH, MDPI, vol. 18(6), pages 1-14, March.
    4. Liangfei Qiu & Subodha Kumar & Arun Sen & Atish P. Sinha, 2022. "Impact of the Hospital Readmission Reduction Program on hospital readmission and mortality: An economic analysis," Production and Operations Management, Production and Operations Management Society, vol. 31(5), pages 2341-2360, May.
    5. Kyaien O. Conner & Tamara Cadet & Monique J. Brown & Joshua T. Barnett, 2018. "The Impact of Peer Support on the Risk of Future Hospital Readmissions among Older Adults with a Medical Illness and Co-Occurring Depression," Social Sciences, MDPI, vol. 7(9), pages 1-11, September.

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