Racial/Ethnic Disparities in Readmissions in US Hospitals

The Role of Insurance Coverage

Bibliographic Data

ID13775879
AuthorsJayasree Basu (0000-0002-1494-9773, Agency for Healthcare Research and Quality, Rockville, MD, USA, corresponding author), Amresh Hanchate (0000-0002-7038-4463, Boston University, MA, USA), Arlene Bierman (Agency for Healthcare Research and Quality, Rockville, MD, USA)
Year2018
Volume55
Pages46958018774180-46958018774180
Publication date2018-01-01
Open AccessYes
TypeARTICLE
VenueINQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL)
Journal identifiersISSN: 0046-9580 • E-ISSN: 1945-7243
PublisherSAGE Publishing (PUBLISHER • US)
DOI10.1177/0046958018774180
PMID29730971
OpenAlexW2599097103
LanguageEN
Citations received6
References cited41

We examine differences in rates of 30-day readmissions across patients by race/ethnicity and the extent to which these differences were moderated by insurance coverage. We use hospital discharge data of patients in the 18 years and above age group for 5 US states, California, Florida, Missouri, New York, and Tennessee for 2009, the latest year prior to the start of Centers for Medicare & Medicaid Services' Hospital Compare program of public reporting of hospital performance on 30-day readmissions. We use logistic regression models by state to estimate the association between insurance status, race, and the likelihood of a readmission within 30 days of an index hospital admission for any cause. Overall in 5 states, non-Hispanic blacks had a slightly higher risk of 30-day readmissions relative to non-Hispanic whites, although this pattern varied by state and insurance coverage. We found higher readmission risk for non-Hispanic blacks, compared with non-Hispanic whites, among those covered by Medicare and private insurance, but lower risk among uninsured and similar risk among Medicaid. Hispanics had lower risk of readmissions relative to non-Hispanic whites, and this pattern was common across subgroups with private, Medicaid, and no insurance coverage. Uninsurance was associated with lower risk of readmissions among minorities but higher risk of readmissions among non-Hispanic whites relative to private insurance. The study found that risk of readmissions by racial ethnic groups varies by insurance status, with lower readmission rates among minorities who were uninsured compared with those with private insurance or Medicare, suggesting that lower readmission rates may not always be construed as a good outcome, because it could result from a lack of insurance coverage and poor access to care, particularly among the minorities

Actuarial science · Business · Ethnic group · Political science · Emergency and Acute Care Studies · Geriatric Care and Nursing Homes · Healthcare Policy and Management

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