Racial Disparities in Age at Preventable Hospitalization Among U.S. Adults

Abstract

Similar to the well-documented racial inequities in health status, disease burden, healthcare access, and hospitalization, studies have generally found higher rates of hospitalization resulting from ambulatory care-sensitive conditions for blacks compared to whites. Beyond identifying disparity in rates of disease or risks of hospitalization, identifying disparity in age at hospitalization may provide deeper insight into the social and economic effects of disparities on individuals, families, and communities. The objective of this paper is to evaluate potential racial disparities in age of preventable hospitalizations as measured by ambulatory care-sensitive conditions. Differences in mean age at hospitalization for ambulatory care-sensitive conditions were evaluated in a nationally representative sample of 6815 hospital discharges using the 2005 National Hospital Discharge Survey. Linear regression using robust SE procedures was used to evaluate differences among nine chronic and three acute conditions. Analyses were conducted in 2008. After adjustment for sociodemographic characteristics, blacks were hospitalized > or =5 years earlier than whites across all conditions combined and for chronic and acute conditions separately. The largest differences were seen for uncontrolled diabetes (adjusted difference= -12.0 years) and bacterial pneumonia (adjusted difference= -7.5 years). Racial disparities in age at preventable hospitalization exist across a spectrum of conditions. This difference in age at hospitalization places an undue burden on individuals, families, and society with long-term health and financial sequelae. Promoting equity in disease prevention, management, and treatment should be a priority of any healthcare reform efforts.