Disparities in Nursing Home Use and Quality Among African American, Hispanic, and White Medicare Residents With Alzheimer's Disease and Related Dementias

J Aging Health. 2019 Aug;31(7):1259-1277. doi: 10.1177/0898264318767778. Epub 2018 May 2.

Abstract

Objective: This article examines differences in nursing home use and quality among Medicare beneficiaries, in both Medicare Advantage and fee-for-service, newly admitted to nursing homes with Alzheimer's disease and related dementias (ADRD). Method: Retrospective, national, population-based study of Medicare residents newly admitted to nursing homes with ADRD by race and ethnic group. Our analytic sample included 1,302,099 nursing home residents-268,181 with a diagnosis of ADRD-in 13,532 nursing homes from 2014. Results: We found that a larger share of Hispanic Medicare residents that are admitted to nursing homes have ADRD compared with African American and White beneficiaries. Both Hispanics and African Americans with ADRD received care in segregated nursing homes with fewer resources and lower quality of care compared with White residents. Discussion: These results have implications for targeted efforts to achieve health care equity and quality improvement efforts among nursing homes that serve minority patients.

Keywords: Alzheimer’s disease and dementia; Hispanics with dementia; disparities among dementia residents; nursing home disparities.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / ethnology
  • Alzheimer Disease / therapy*
  • Black or African American / statistics & numerical data*
  • Facilities and Services Utilization
  • Fee-for-Service Plans
  • Female
  • Healthcare Disparities / ethnology*
  • Hispanic or Latino / statistics & numerical data*
  • Hospitalization
  • Humans
  • Male
  • Medicare
  • Nursing Homes / statistics & numerical data*
  • Retrospective Studies
  • United States
  • White People / statistics & numerical data*