Smith, J.M.; Jarrín, O.F.; Lin, H.; Tsui, J.; Dharamdasani, T.; Thomas-Hawkins, C. Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes. Int. J. Environ. Res. Public Health2021, 18, 3196.
Smith, J.M.; Jarrín, O.F.; Lin, H.; Tsui, J.; Dharamdasani, T.; Thomas-Hawkins, C. Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes. Int. J. Environ. Res. Public Health 2021, 18, 3196.
Smith, J.M.; Jarrín, O.F.; Lin, H.; Tsui, J.; Dharamdasani, T.; Thomas-Hawkins, C. Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes. Int. J. Environ. Res. Public Health2021, 18, 3196.
Smith, J.M.; Jarrín, O.F.; Lin, H.; Tsui, J.; Dharamdasani, T.; Thomas-Hawkins, C. Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes. Int. J. Environ. Res. Public Health 2021, 18, 3196.
Abstract
Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.
Keywords
Chronic conditions; diabetes; older adults; race or ethnicity; health care access; home health care; social determinants of health; inequalities or inequities
Subject
Public Health and Healthcare, Nursing
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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