Health Affairs Web First: Significant Racial Disparities Found In Hospital Readmissions

Reducing thirty-day surgical readmission rates has been a major initiative under the Hospital Readmissions Reduction Program of the Affordable Care Act (ACA). Racial disparities in surgical outcomes, such as thirty-day hospital rehospitalizations have been well documented—and a new study, released by Health Affairs as a Web First, contributes to those findings. The study, which sampled New York fee-for-service Medicare and Medicare Advantage patients who received surgery in 2013, finds that black patients in traditional Medicare were 33 percent more likely than white patients to be readmitted to the hospital within thirty days.

For Medicare Advantage patients, the likelihood nearly doubled, to 64 percent. The study sample was limited to patients ages sixty-five and older who received one of the following six major surgeries:  isolated coronary artery bypass graft, pulmonary lobectomy, endovascular repair of abdonominal aortic aneurysm, open repair of abdominal aortic aneurysm, colectomy, and hip replacement.

“Our findings suggest that the risk-reduction strategies adopted by Medicare Advantage plans have not succeeded in lowering the markedly higher rates of readmission for black patients compared to white patients,” the authors Yue Li, Xi Cen, Xueya Cai, Caroline P. Thirukumaran, Jie Zhou, and Laurent G. Glance conclude. “Future qualitative research is necessary to understand which specific managed care approaches may be effective in reducing thirty-day readmissions for white and black beneficiaries, and why existing Medicare Advantage plans do not seem to be successful in reducing racial disparity in thirty-day surgical readmissions.”

Li, Cen, Cai, Thirukumaran, and Glance are affiliated with the University of Rochester School of Medicine and Dentistry; Zhou is with Harvard Medical School and  Brigham and Women’s Hospital.

This study will also appear in the July issue of Health Affairs.

 

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