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Study Finds Black Medicare Less Likely to Be Referred for Home Health Care

22% of Black patients are referred to home health care after hospital discharge, compared with 27% of white patients

December 14, 2023  – The latest research published in Medical Care reveals a concerning trend in the healthcare sector. Black Medicare beneficiaries are less likely to be referred for home health care (HHC) post-hospitalization compared to their White peers. This disparity underscores a critical issue in healthcare equity and equality.

This research probes into the decision-making processes surrounding post-hospitalization care, specifically examining the influence of racial factors in the referral for home health services. The current study analyzed 14,684 cases involving Medicare beneficiaries, focusing on how nurses’ assessments of patients’ readiness for discharge influenced the referral to home health services across different racial and ethnic groups.

The study found that the readiness for discharge scores were comparable among different racial and ethnic groups. Despite this similarity in assessment, Black patients were notably less likely to be referred for HHC. In fact, only 22% of Black patients were referred to home health care, compared with 27% of white patients. 

Why does it matter? Simply put, home health care is an integral part of the recovery process for patients discharged from hospitals. These services ensure continuity of care and can reduce the risks of adverse health outcomes and potential readmissions. This proof of the value of home health care after discharge lies in readmission rates. Black patients had the highest hospital readmission rate at 15%. This compares to 10% for white patients, 13% for Hispanic patients and 12% for other races.

Dr. Yakusheva, the lead researcher with the University of Michigan School of Nursing and Public Health, and her colleagues acknowledge the nuances of this issue. Factors such as potential biases in the healthcare system, cultural differences in patient assessments, patient preferences, and communication gaps can all contribute to this disparity. These elements represent areas within the scope of healthcare institutions that require urgent attention and reform.

The study concludes with a call to action for healthcare systems. It emphasizes the need for active engagement with stakeholders from diverse racial and ethnic backgrounds to better understand the issues at hand and develop solutions that address systemic injustices in healthcare settings. 

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