SHM Converge Scientific Abstract ePoster Gallery-Racial Disparities in Discharge to Post-Acute Care Facilities

Pdf Summary

This study examined racial disparities in discharge to post-acute care (PAC) facilities among adults hospitalized for acute medical illness. The authors focused on whether Black patients were less likely than non-Black patients to be recommended for PAC discharge or to actually be discharged to PAC when recommended, and whether social disadvantage influenced these associations.<br /><br />Using hospital medicine admissions lasting at least 48 hours from January 2018 to May 2022, the researchers performed regression analyses adjusting for age, sex, length of stay, admission mobility, mobility change during hospitalization, neighborhood disadvantage (Area Deprivation Index), and insurance type.<br /><br />Black patients in the sample had greater social disadvantage and were more likely to have Medicare/Medicaid coverage. They also had slightly lower mobility scores at discharge. The study found that Black race was not significantly associated with receiving a recommendation for PAC discharge. However, Black patients had lower odds of actually being discharged to a PAC facility overall, and also lower odds of discharge to PAC among those for whom PAC had been recommended.<br /><br />These disparities persisted in several subgroups, including older adults and patients living in neighborhoods with the least social disadvantage. However, among patients in the most socially disadvantaged neighborhoods, the association between Black race and discharge to PAC when recommended was not statistically significant.<br /><br />The authors conclude that Black patients face disparities in access to post-acute rehabilitation after hospitalization, even when such care is recommended. They suggest that clinicians and discharge protocols should account for these inequities to help ensure Black patients receive appropriate post-acute care and support for functional recovery.

Asset Subtitle

Maylyn Martinez

Meta Tag

Author List David O. Meltzer, Maylyn Martinez, Monica Peek, Rachel Baccile, Vineet Arora

Category Research

Concept Post-Acute Care Facility

Concept Racial Disparity

Concept Black Patients

Concept Discharge Recommendation

Concept Actual Discharge

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Maylyn Martinez

Track Transitions of Care

Keywords

racial disparities

Black patients

post-acute care

PAC discharge

hospitalization

acute medical illness

discharge recommendation

social disadvantage

Area Deprivation Index

rehabilitation access

Post-Acute Care Facility

Racial Disparity

Black Patients

Discharge Recommendation

Actual Discharge