Black and Hispanic patients with diabetes are more likely than white patients to be readmitted to the hospital within 6 months after their initial hospitalization for complications associated with diabetes. These complications are potentially preventable with effective postdischarge care, according to a study by researchers at the Agency for Healthcare Research and Quality. Study findings suggest that disparities in diabetes-related outcomes are more likely due to differences in outpatient management of the disease than to the quality of inpatient care.
Researchers analyzed the likelihood of readmission within 6 months for adult black, Hispanic, and white patients with diabetes in 5 States who had been hospitalized for conditions related to diabetes. The patients were identified from the 1999 State Inpatient Databases of the Healthcare Cost and Utilization Project. After adjusting for hospital and patient characteristics, the likelihood of readmission to the hospital within 6 months was significantly higher for Hispanics than for whites across the three payer groups: Medicare, Medicaid, and private insurance. Black patients insured by Medicare were more likely than white patients to be readmitted within 6 months.
In the Medicare subgroup, blacks and Hispanics had higher percentages of readmissions for acute and microvascular complications (for example, lower extremity and renal disease), while whites had higher percentages of readmissions for macrovascular conditions (for example, heart attack and stroke). This pattern was less evident in the private or Medicaid groups. Across all payers, blacks were more likely to be readmitted for acute complications, Hispanics for diabetes-related renal disease, and whites for heart disease.
More details are in "Racial/ethnic disparities in potentially preventable readmissions: The case of diabetes," by H. Joanna Jiang, Ph.D., Roxanne Andrews, Ph.D., Daniel Stryer, M.D., and Bernard Friedman, Ph.D., in the September 2005 American Journal of Public Health 95(9), pp. 1561-1567. Reprints (AHRQ Publication No. 05-R071) are available from the AHRQ Publications Clearinghouse.