Blacks Are Less Likely Than Whites to Be Referred to Home Health Care After Hospital Discharge

When discharging Black patients from the hospital, nurses are less likely to refer them to home health care than White patients, a new University of Michigan study found.

The study found that despite a higher likelihood that Black patients were unmarried, lived alone, and had more chronic conditions — all risk factors for hospital readmission — they were routinely rated equally ready for hospital discharge as White patients. About 22 percent of Black patients are referred by discharge nurses to home health care compared to 27 percent of White patients.

In other words, Black patients had to be considerably less ready to go home than White patients to have the same odds of getting a home care referral.

The study also found that Black patients had the highest readmission rate at 15 percent, compared to 10 percent for White patients.

“With Black patients, the difference in referral rates was observed against the combined backdrop of the elevated risk profile in addition to poor observed outcome of care,” said Olga Yakusheva, lead author and professor at the University of Michigan School of Nursing and School of Public Health. “So, for Black patients, the observed data are consistent with a potential failure of the health care system to provide appropriate care.”

The full study, “Racial and Ethnic Disparities in Home Health Referral Among Adult Medicare Patients,” was published in the journal Medical Care. It may be accessed here.

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