Black and non-Hispanic white Medicare beneficiaries living with dementia have a higher burden of 30-day readmission rates than their peers without dementia, a new study finds. The results suggest a variety of reasons that contribute to these disparities, the authors report.
Investigators conducted a retrospective cohort study using 100% Medicare fee-for-service claims. The data included all hospitalizations during 2014 of people with a dementia diagnosis.
Fully 21% of Black patients and 18% of white patients with dementia were likely to be readmitted to the hospital within 30 days of their original stay when compared to an average rate of 14% readmissions for Medicare beneficiaries without dementia, study lead Andrea Gilmore-Bykovskyi, PhD, RN, of the University of Madison-Wisconsin reported.
The researchers also found substantial racial and geographic disparities in 30-day readmission rates. For example, Black Medicare beneficiaries with dementia had elevated rates when compared to non-Hispanic whites with dementia, no matter whether they had socially protective factors including education, jobs and housing as indicated by a validated measure. The latter findings “may reflect differences in access to care and/or treatment,” that could explain these higher rates, the authors wrote.
In addition, non-Hispanic white beneficiaries with dementia who reside in the most disadvantaged neighborhood settings had higher 30-day readmission rates compared to same-race peers exposed to lower levels of neighborhood disadvantage.
Readmissions can dramatically increase care costs and the burden for people living with dementia, the researchers wrote. “Structural inequities and racism should be evaluated as potential drivers of and contributors to address fundamental drivers of disparities,” they concluded.
Full findings were published in the Journal of the American Geriatrics Society.
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