Pressure Ulcer Prevalence Among Black and White Nursing Home Residents in New York State

Evidence of Racial Disparity

Datos Bibliográficos

ID9101795
AutoresShubing Cai (0000-0002-4695-0760, Brown University, autor de correspondencia), Dana B Mukamel (0000-0003-4147-5785), Helena Temkin‐greener (0000-0001-6113-2953, University of Rochester), Helena Temkin-Greener
Año2010
Volumen48
Número3
Páginas233-239
Fecha de publicación2010-03-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181ca2810
PMID20182267
PMCIDPMC3313600
OpenAlexW2059963930
IdiomaEN
Citas recibidas7
Referencias citadas30

OBJECTIVE: The occurrence of pressure ulcers (PUs) in nursing homes is a marker for poor quality of care. We examine whether differences in PU prevalence between black and white residents are due to within- or across-facility disparities. METHODS: Minimum Data Sets (2006-2007) are linked with the Online Survey Certification and Reporting database. Long-term care residents with high risk for PUs are identified. The dependent variable is dichotomous, indicating PU presence/absence. Individual race and facility race-mix are the main variables of interests.The sample includes 59,740 long-term care high-risk residents (17.4% black and 82.6% white) in 619 nursing homes. We fit 3 risk-adjusted logit models: base, conditional fixed-effects, and random-effects. RESULTS: Unadjusted PU prevalence is 14.5% (18.2% for blacks and 13.8% for whites). Overall, blacks are more likely to have PUs than whites, controlling for individual risk factors. We find no such effect within facilities after additional accounting for facility fixed effects. The effect of race is significantly different between the base and the conditional fixed-effects logit model. The random-effects and conditional fixed-effects logit models show similar results, demonstrating that higher PU presence among blacks is associated with greater facility-specific concentration of black residents. CONCLUSION: Greater PU occurrence among blacks may not result from differential within-facility treatment of blacks versus whites. Rather, blacks are more likely to reside in facilities with poorer care quality. To improve PU care for blacks, efforts should focus on improving the overall quality of care for facilities with high proportion of black residents

Nursing homes · White (mutation) · Elder Abuse and Neglect · Geriatric Care and Nursing Homes · Medicine · Nursing · Pressure Ulcer Prevention and Management · Gerontology