Racial Disparities in Age at Preventable Hospitalization Among U.S. Adults

Biello, Katie B.; Rawlings, James S.; Carroll‐Scott, Amy; Browne, Rosa; Ickovics, Jeannette R.

doi:10.1016/j.amepre.2009.08.027

Cited by 42 publications

(41 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…De outra parte, estudos americanos revelam que, para categorias étnicas socialmente excluídas, é mais difícil o acesso aos serviços básicos de saúde, e, com isso, há carência de ações de prevenção, falta de diagnóstico e tratamento precoce, o que acarreta complicações das doenças e aumento das internações sensíveis 24,25 .…”

Section: Discussionunclassified

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

Pazó

Frauches²,

Maria

et al. 2014

Cad. Saúde Pública

View full text Add to dashboard Cite

O objetivo deste estudo foi investigar a associação entre a organização dos serviços de saúde e as taxas de internações hospitalares por condições sensíveis à atenção primária após ajuste para variáveis socioeconômicas e demográficas no contexto dos municípios do Espírito Santo, Brasil. Estudo ecológico das internações do Sistema Único de Saúde (SUS) com as variáveis: internações hospitalares por condições sensíveis à atenção primária, porte municipal, indicadores demográficos, socioeconômicos, organização e indicadores de desempenho dos serviços de saúde. Realizou-se análise multivariável por regressão de Poisson com ajuste robusto da variância. Foram ajustados modelos para a população total e por faixas etárias. Ordenaram-se as variáveis explicativas segundo modelo hierarquizado. Houve associação a risco de internações hospitalares por condições sensíveis à atenção primária com o percentual de analfabetismo (RR: 1,08-1,17), proporção de leitos SUS (RR: 1,09-1,12), urbanização (RR: 1,02-1,03), proporção de negros (RR: 0,97-0,98) e cobertura de plano de saúde (RR: 0,97-0,98). Há determinantes das internações hospitalares por condições sensíveis à atenção primária que implicam no padrão de utilização dos serviços e estão fora do escopo da atenção primária.

show abstract

Section: Discussionunclassified

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

Pazó

Frauches²,

Maria

et al. 2014

Cad. Saúde Pública

View full text Add to dashboard Cite

show abstract

“…Race is associated with disparate clinical outcomes in multiple health conditions (1). Such disparities are particularly conspicuous in diabetes, where racial minorities have higher rates of microvascular complications and mortality (2).…”

Section: Introductionmentioning

confidence: 99%

“…Such disparities are particularly conspicuous in diabetes, where racial minorities have higher rates of microvascular complications and mortality (2). Compared to other racial groups, blacks with diabetes make more frequent emergency department visits for hyperglycemia and hypoglycemia (3–5), are hospitalized at younger ages (1), have higher readmission rates(6), and experience more preventable complications (2). Among the complications of diabetes, the racial gap in disease incidence is widest in nephropathy; blacks are nearly four times more likely to progress to end-stage renal disease compared to their white counterparts(2).…”

Section: Introductionmentioning

confidence: 99%

Racial differences in acute kidney injury of hospitalized adults with diabetes

Mathioudakis

Giles

Yeh

et al. 2016

Journal of Diabetes and its Complications

View full text Add to dashboard Cite

Objective To determine whether there is a racial difference in the risk of acute kidney injury between hospitalized black and white adults with diabetes mellitus in the United States Research Design and Methods We analyzed cross-sectional data from the 2000–2010 National Hospital Discharge Survey (NHDS) to compare the odds of AKI among hospitalized black and white adults with diabetes. After excluding records in which race status was missing, race was other than white or black, discharge status was not provided, or end-stage renal disease was a diagnosis, we identified 276,138 eligible records for analysis. Multivariable logistic regression was used to analyze the association between race, AKI, and in-hospital mortality. Multivariable linear regression was used to analyze the association between length of stay and race among discharge records with a diagnosis of AKI. Results In this nationally representative sample of hospitalized U.S. adults with diabetes, blacks had a 50% higher age- and sex-adjusted odds of AKI compared to whites (odds ratio: 1.51; 95% CI 1.37–1.66). The association between black race and increased risk of AKI persisted after additional adjustment for multiple AKI-related risk factors, including chronic kidney disease, sepsis, hypertension, hypotension, length of stay, myocardial infarction, congestive heart failure, angiography, computed tomography scan, cirrhosis, admission source, payor source, hospital region, and hospital bedsize (OR 1.71; 95% CI, 1.31–2.25). Among cases of AKI, there was no racial difference in length of stay or in-hospital mortality. Conclusions Among hospitalized adults in the U.S. with diabetes, black race is associated with a higher risk of AKI compared to white race.

show abstract

“…9 Recent studies have identified that psychosocial factors such as race, socioeconomic status and mental disorders may increase the risk of hospitalizations for ACSCs. 7,[10][11][12][13] Of the potential psychosocial risk factors for hospitalizations for ACSCs identified, mental disorders represent an area that could be amenable to intervention, and thus may reduce the number and cost of potentially preventable hospitalizations.…”

Section: Introductionmentioning

confidence: 99%

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

et al. 2013

View full text Add to dashboard Cite

BACKGROUND: Hospitalizations for ambulatory caresensitive conditions (ACSCs), conditions that should not require inpatient treatment if timely and appropriate ambulatory care is provided, may be an important contributor to rising healthcare costs and public health burden. OBJECTIVE: To examine if probable major depression is independently associated with hospitalization for an ACSC in patients with diabetes. DESIGN: Secondary analysis of data from a prospective cohort study. PARTICIPANTS: Population-based cohort of 4,128 patients with diabetes ≥ 18 years old seen in primary care, who were enrolled between 2000 and 2002 and followed for 5 years (through 2007). MAIN MEASURES: Depressive symptoms were assessed with the Patient Health Questionnaire-9. Outcomes of interest included time to initial hospitalization for an ACSC and total number of ACSC-related hospitalizations. We used Cox proportional hazards regression models to ascertain an association between probable major depression and time to ACSC-related hospitalization, as well as Poisson regression for models examining probable major depression and number of ACSC-related hospitalizations. KEY RESULTS: Patients' mean age at study enrollment was 63.4 years (Standard Deviation: 13.4 years). Over the 5-year follow-up period, 981 patients in the study were hospitalized a total of 1,721 times for an ACSC, comprising 45.1 % of all hospitalizations. After adjusting for baseline demographic, clinical and health-risk behavioral factors, probable major depression was associated with initial ACSC-related hospitalization (Hazard Ratio: 1.41, 95 % Confidence Interval [95 % CI]: 1.15, 1.72) and number of ACSC-related hospitalizations (Relative Risk: 1.37, 95 % CI: 1.12, 1.68). CONCLUSIONS: Probable major depression in patients with diabetes is independently associated with hospitalization for an ACSC. Additional research is warranted to ascertain if effective interventions for depression in patients with diabetes could reduce the risk of hospitalizations for ACSCs and their associated adverse outcomes.

show abstract

Racial Disparities in Age at Preventable Hospitalization Among U.S. Adults

Cited by 42 publications

References 26 publications

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

Modelagem hierárquica de determinantes associados a internações por condições sensíveis à atenção primária no Espírito Santo, Brasil

Racial differences in acute kidney injury of hospitalized adults with diabetes

Depression and Risk of Hospitalizations for Ambulatory Care-Sensitive Conditions in Patients with Diabetes

Contact Info

Product

Resources

About