Not so black and white: nursing home concentration of Hispanics associated with prevalence of pressure ulcers

Abstract

Objective: To examine the association between the nursing home (NH) concentration of Hispanics and prevalence of pressure ulcer.

Design: Secondary data analysis using data from the national repository of the 2000 Minimum Data Set (MDS) and On-Line Survey Certification and Reporting (OSCAR) data. We used a multivariate logistic model, with the Huber-White correction to account for clustering of persons within a nursing facility, to examine the association of Hispanic NH concentration with the prevalence of pressure ulcers, after adjusting for resident level characteristics.

Setting: Five states with a high population of Mexican-Americans (California, New Mexico, Arizona, Colorado, and Texas).

Participants: A total of 74,343 persons (9.26% black, 11.28% Hispanic, 79.46% non-Hispanic white) in a NH located in 1 of these 5 states during the last quarter of 2000.

Measurements: The prevalence of Stage II-IV pressure ulcers was examined in the last quarter of 2000. Stage II-IV pressure ulcers, resident demographics, and medical illness data were documented by nursing staff on the MDS.

Results: Hispanics and non-Hispanic blacks had a higher prevalence of pressure ulcers than non-Hispanic whites (7.60%, 9.71% and 12.10%, respectively). A facility's concentration of Hispanic residents was associated with prevalent pressure ulcers after adjustment for resident characteristics.

Conclusions: Residents in nursing homes in which there is a higher concentration of Hispanic residents are more likely to have a pressure ulcer.

Fig. 1

Stage II–IV pressure ulcer according to proportion of Hispanic NH residents. Quintile 1: 0% Hispanic residents, quintile 2: > 0% to < 3.0% Hispanic residents, quintile 3: ≥ 3.0 % to < 10% Hispanic residents, quintile: 4: ≥ 10% to 20% Hispanic residents, and quintile 5: ≥ 20% Hispanic residents.