Racial Disparities in 7-Day Readmissions from an Adult Hospital Medicine Service

Rambachan, Aksharananda; Abe-Jones, Yumiko; Fernández, Alicia; Shahram, Yalda

doi:10.1007/s40615-021-01088-3

Cited by 4 publications

(1 citation statement)

References 23 publications

(35 reference statements)

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“…25 The disparities data embedded in the survey question highlighted a racialized gap in 7-day readmission, length-of-stay, and opioid prescribing practice within the respondent's institution. 28 The theme of Data Motivates Action was expressed by nearly every respondent, exemplified by this quote: "If I see data that shows disparities that my clinical care is contributing towards, that spurns me to take discrete action." Additional themes emerged when analyzing the free text response to the question prompt: "How do you or do you not feel empowered [to address health care disparities]?"…”

Section: Program Evaluationmentioning

confidence: 99%

The Tea House Series: Striving Together to be Antiracist

2022

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Background Though awareness of health care structures that are racist and oppressive is increasing among health care professionals, there is a gap in continuing education curricula focused on antiracist anti-oppressive practices, and limited faculty and staff development to guide individuals towards action. Aim To develop, implement, and evaluate a novel antiracist faculty and staff development program called the Tea House Series. Setting and Participants A five-part continuing education series with an accompanying online community for faculty and staff at the divisions of Hospital Medicine in one institution in the western United States. Program Description The four foundational pillars integral to the Tea House Series were as follows: educational framework based on the pedagogy of Paulo Freire, local disparities data, welcoming space to establish a community of practice and accountability. Each session contained participant dialogue in small group activities. Program Evaluation Qualitative analysis of participant survey responses demonstrated transformation towards a hope to act with a sense of community. Quantitative analysis measured increased confidence for the program learning objectives. Discussion The Tea House Series may be used as a model for continuing education to provide the tools and the community to confront systems of racism and oppression in any institution.

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Section: Program Evaluationmentioning

confidence: 99%

The Tea House Series: Striving Together to be Antiracist

2022

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Emergency department encounters and opioid prescribing following orthopaedic trauma among Black and White patients with substance use disorders

Kee,

Schenker,

Moran

et al. 2024

Journal of Substance Use and Addiction Treatment

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Association between language discordance and unplanned hospital readmissions or emergency department revisits: a systematic review and meta-analysis

Chu,

Wong,

Bardach

et al. 2023

BMJ Qual Saf

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Background and objectiveStudies conflict about whether language discordance increases rates of hospital readmissions or emergency department (ED) revisits for adult and paediatric patients. The literature was systematically reviewed to investigate the association between language discordance and hospital readmission and ED revisit rates.Data sourcesSearches were performed in PubMed, Embase and Google Scholar on 21 January 2021, and updated on 27 October 2022. No date or language limits were used.Study selectionArticles that (1) were peer-reviewed publications; (2) contained data about patient or parental language skills and (3) included either unplanned hospital readmission or ED revisit as one of the outcomes, were screened for inclusion. Articles were excluded if: unavailable in English; contained no primary data or inaccessible in a full-text form (eg, abstract only).Data extraction and synthesisTwo reviewers independently extracted data using Preferred Reporting Items for Systematic Reviews and Meta-Analyses-extension for scoping reviews guidelines. We used the Newcastle-Ottawa Scale to assess data quality. Data were pooled using DerSimonian and Laird random-effects models. We performed a meta-analysis of 18 adult studies for 28-day or 30-day hospital readmission; 7 adult studies of 30-day ED revisits and 5 paediatric studies of 72-hour or 7-day ED revisits. We also conducted a stratified analysis by whether access to interpretation services was verified/provided for the adult readmission analysis.Main outcome(s) and measure(s)Odds of hospital readmissions within a 28-day or 30-day period and ED revisits within a 7-day period.ResultsWe generated 4830 citations from all data sources, of which 49 (12 paediatric; 36 adult; 1 with both adult and paediatric) were included. In our meta-analysis, language discordant adult patients had increased odds of hospital readmissions (OR 1.11, 95% CI 1.04 to 1.18). Among the 4 studies that verified interpretation services for language discordant patient-clinician interactions, there was no difference in readmission (OR 0.90, 95% CI 0.77 to 1.05), while studies that did not specify interpretation service access/use found higher odds of readmission (OR 1.14, 95% CI 1.06 to 1.22). Adult patients with a non-dominant language preference had higher odds of ED revisits (OR 1.07, 95% CI 1.004 to 1.152) compared with adults with a dominant language preference. In 5 paediatric studies, children of parents language discordant with providers had higher odds of ED revisits at 72 hours (OR 1.12, 95% CI 1.05 to 1.19) and 7 days (OR 1.02, 95% CI 1.01 to 1.03) compared with patients whose parents had language concordant communications.DiscussionAdult patients with a non-dominant language preference have more hospital readmissions and ED revisits, and children with parents who have a non-dominant language preference have more ED revisits. Providing interpretation services may mitigate the impact of language discordance and reduce hospital readmissions among adult patients.PROSPERO registration numberCRD42022302871.

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Racial Disparities in 7-Day Readmissions from an Adult Hospital Medicine Service

Cited by 4 publications

References 23 publications

The Tea House Series: Striving Together to be Antiracist

The Tea House Series: Striving Together to be Antiracist

Emergency department encounters and opioid prescribing following orthopaedic trauma among Black and White patients with substance use disorders

Association between language discordance and unplanned hospital readmissions or emergency department revisits: a systematic review and meta-analysis

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