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ABSTRACT: Importance
Differences in readmission rates among racial and ethnic minorities have been reported, but data among people with diabetes are lacking despite the high burden of diabetes and its complications in these populations.Objectives
To examine racial/ethnic differences in all-cause readmission among US adults with diabetes and categorize patient- and system-level factors associated with these differences.Design, setting, and participants
This retrospective cohort study includes 272?758 adult patients with diabetes, discharged alive from the hospital between January 1, 2009, and December 31, 2014, and stratified by race/ethnicity. An administrative claims data set of commercially insured and Medicare Advantage beneficiaries across the United States was used. Data analysis took place between October 2016 and February 2019.Main outcomes and measures
Unplanned all-cause readmission within 30 days of discharge and individual-, clinical-, economic-, index hospitalization-, and hospital-level risk factors for readmission.Results
A total of 467?324 index hospitalizations among 272?758 adults with diabetes (mean [SD] age, 67.7 [12.7]; 143?498 [52.6%] women) were examined. The rates of 30-day all-cause readmission were 10.2% (33?683 of 329?264) among white individuals, 12.2% (11?014 of 89?989) among black individuals, 10.9% (4151 of 38?137) among Hispanic individuals, and 9.9% (980 of 9934) among Asian individuals (P?Conclusions and relevanceIn this study, black patients with diabetes had a significantly higher risk of readmission than members of other racial/ethnic groups. This increased risk was most pronounced among lower-income patients hospitalized in nonprofit, academic, or large hospitals. These findings reinforce the importance of identifying and addressing the many reasons for persistent racial/ethnic differences in health care quality and outcomes.
SUBMITTER: Rodriguez-Gutierrez R
PROVIDER: S-EPMC6804020 | biostudies-literature | 2019 Oct
REPOSITORIES: biostudies-literature
JAMA network open 20191002 10
<h4>Importance</h4>Differences in readmission rates among racial and ethnic minorities have been reported, but data among people with diabetes are lacking despite the high burden of diabetes and its complications in these populations.<h4>Objectives</h4>To examine racial/ethnic differences in all-cause readmission among US adults with diabetes and categorize patient- and system-level factors associated with these differences.<h4>Design, setting, and participants</h4>This retrospective cohort stud ...[more]