Key result
Black race links to ~62% higher unadjusted 30-day readmission risk in CVD, attenuating after adjustment.
Why the study?
Factors contributing to racial differences in 30-day readmissions among patients hospitalized with cardiovascular disease were not well defined.
Observational (n=734)
No
Racial disparities in 30-day readmission rates among cardiovascular disease patients are largely driven by differences in socioeconomic, psychosocial, and healthcare-related factors rather than race alone.
Answers are grounded in this paper and cite their sources.
Supports addressing socioeconomic factors to reduce readmission disparities; hypothesis-generating for targeted interventions.
OBJECTIVE: To examine factors contributing to racial differences in 30-day readmission in patients with cardiovascular disease (CVD). DESIGN: Patients were enrolled from 1 January 2015 to 31 August 2017 and data were collected from electronic health records and a standardised interview administered prior to discharge. SETTING: Duke Heart Center in the Duke University Health System. PARTICIPANTS: Patients aged 18 and older admitted for the treatment of cardiovascular-related conditions (n=734). MAIN OUTCOME AND MEASURES: All-cause readmission within 30 days was the main outcome. Multivariate logistic regression models were used to examine whether and to what extent socioeconomic, psychosocial, behavioural and healthcare-related factors contributed to 30-day readmissions in Black and White CVD patients. RESULTS: The median age of patients was 66 years and 18.1% (n=133) were readmitted within 30 days after discharge. Black patients were more likely than White patients to be readmitted (OR 1.62; 95% CI 1.18 to 2.23) and the racial difference in readmissions was largely reduced after taking into account differences in a wide range of clinical and non-clinical factors (OR 1.37; 95% CI 0.98 to 1.91). In Black patients, readmission risks were especially high in those who were retired (OR 3.71; 95% CI 1.71 to 8.07), never married (OR 2.21; 95% CI 1.21 to 4.05), had difficulty accessing their routine care (OR 2.88; 95% CI 1.70 to 4.88) or had been hospitalised in the prior year (OR 1.97; 95% CI 1.16 to 3.37). In White patients, being widowed (OR 2.39; 95% CI 1.41 to 4.07) and reporting a higher number of depressive symptoms (OR 1.07; 95% CI 1.00 to 1.13) were the key factors associated with higher risks of readmission. CONCLUSIONS AND RELEVANCE: Black patients were more likely than White patients to be readmitted within 30 days after hospitalisation for CVD. The factors contributing to readmission differed by race and offer important clues for identifying patients at high risk of readmission and tailoring interventions to reduce these risks.
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Farmer et al. (2022) conducted an observational in Cardiovascular disease (n=734). Black race vs. White race was evaluated on All-cause readmission within 30 days (OR 1.62, 95% CI 1.18-2.23). Black patients with cardiovascular disease had a higher unadjusted risk of 30-day readmission than White patients (OR 1.62; 95% CI 1.18-2.23), which was attenuated after adjustment.
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