Effect of Race/ethnicity, Insurance Status, and Area Deprivation on Hip Fracture Outcomes Among Older Adults in the United States

Clin Nurs Res. 2022 Mar;31(3):541-552. doi: 10.1177/10547738211061216. Epub 2021 Nov 23.

Abstract

This retrospective cohort study used electronic health records to explore the effect of race/ethnicity, insurance status, and area deprivation on post-discharge outcomes in older patients undergoing hip fracture surgery between 2015 and 2018 (N = 1,150). Inverse probability of treatment weight-adjusted regression analysis was used to identify the effects of the predictors on outcomes. White patients had higher 90- and 365-day readmission risks than Black patients and higher all-period readmissions than the Other racial/ethnic (Hispanic, Asian, American Indian, and Multicultural) group (p < .000). Black patients had a higher risk of 30- and 90-day readmission than the Other racial/ethnic group (p < .000). Readmission risk across 1-year follow-up was generally higher among patients from less deprived areas than more deprived areas (p < .05). The 90- and 365-day mortality risk was lower for patients from less deprived areas (vs. more deprived areas) and patients with Medicare Advantage (vs. Medicare), respectively (p < .05). Our findings can guide efforts to identify patients for additional post-discharge support. Nevertheless, the findings regarding readmission risks contrast with previous knowledge and thus require more validation studies.

Keywords: aged; hip fractures; racial/ethnic groups; socioeconomic factors; surgery.

MeSH terms

  • Aftercare*
  • Aged
  • Ethnicity*
  • Humans
  • Insurance Coverage
  • Medicare
  • Patient Discharge
  • Patient Readmission
  • Retrospective Studies
  • United States