Abstract 17797: The Impact of Ethnicity and Hospital Ethnic Make-up on 30-Day Readmission Rates for Elderly Hispanic Patients With Heart Failure
Hispanics are the fastest growing segment of the US population, and have a higher prevalence of heart failure (HF) than non-Hispanic whites. However, little is known about the care they receive for HF. We used national Medicare data to determine whether elderly Hispanics had higher readmission rates for HF and if so, whether it was due to the site of care. We examined hospitalizations with a primary discharge diagnosis of HF. We categorized hospitals by the proportion of Hispanic patients they cared for and designated the top decile as “Hispanic-serving.” We built linear regression models with patient ethnicity and hospital Hispanic-serving status as the primary predictors and all-cause 30-day readmission rates as the primary outcome. In risk-adjusted analyses, Hispanic patients had higher readmission rates than whites (26.7% vs. 25.4%, p<0.001). Similarly, Hispanic-serving hospitals had higher readmission rates than non-Hispanic-serving hospitals (26.0% vs. 25.0%, p=0.001). In stratified analyses, we found that ethnic disparities persisted in both sets of hospitals, and readmission rates were higher for both Hispanics and whites at Hispanic-serving hospitals than at non-Hispanic-serving hospitals. Further adjusting for hospital characteristics and the proportion of Medicaid patients had little impact on our findings (Table). In conclusion, elderly Hispanic patients are more likely to be readmitted for HF than elderly whites. These disparities are persistent across both Hispanic-serving and non-Hispanic serving hospitals, although Hispanic-serving hospitals have generally higher readmission rates for all their patients. As the Hispanic population grows, preventing readmissions in this group will become an increasing public health challenge. Our findings suggest that a multi-faceted approach, targeting the site of care as well as these high-risk patients themselves, will be necessary to reduce disparities and improve care for all HF patients.
- © 2010 by American Heart Association, Inc.