Relationships Between Race/Ethnicity and Health Care Utilization Among Older Post-Acute Home Health Care Patients.
Jo-Ana D ChaseDavid RussellLiming HuangAlexandra HanlonMelissa O'ConnorKathryn H BowlesPublished in: Journal of applied gerontology : the official journal of the Southern Gerontological Society (2018)
Few studies have explored racial/ethnic differences in health care outcomes among patients receiving home health care (HHC), despite known differences in other care settings. We conducted a retrospective cohort study examining racial/ethnic disparities in rehospitalization and emergency room (ER) use among post-acute patients served by a large northeastern HHC agency between 2013 and 2014 (N = 22,722). We used multivariable binomial logistic regression to describe the relationship between race/ethnicity and health care utilization outcomes, adjusting for individual-level factors that are conceptually related to health service use. Overall rates of rehospitalization and ER visits were 10% and 13%, respectively. African American and Hispanic patients experienced higher odds of ER visits or rehospitalization during their HHC episode. Racial/ethnic differences in utilization were mediated by enabling factors, such as caregiver availability, and illness-level factors, such as illness severity, functional status, and symptoms. Intervention targets may include early risk assessment, proactive management of clinical conditions, rehabilitative therapy, and caregiver training.
Keyphrases
- healthcare
- end stage renal disease
- risk assessment
- african american
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- randomized controlled trial
- emergency department
- public health
- prognostic factors
- mesenchymal stem cells
- stem cells
- quality improvement
- respiratory failure
- physical activity
- insulin resistance
- climate change
- bone marrow
- smoking cessation
- metabolic syndrome
- human health
- breast cancer cells