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Blacks twice as likely as whites to be readmitted for asthma
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Black children are twice as likely to be readmitted to the hospital for asthma compared with white children, largely due to a greater burden of financial and social hardships, according to recent study results published in Pediatrics.
“Readmission rates are a central focus of health care reform,” Andrew Beck, MD, of Cincinnati Children’s Hospital, said in a press release. “Reducing disparities in such outcomes will be critical, especially since payment reform will be based more on quality outcomes and less so on health care encounters. Our findings suggest a more intense patient- and population-level focus on the financial and social hardships that underlie racial disparities may provide one path for achieving better outcomes. Identifying hardships could prompt partnerships with individuals and agencies poised to provide added community support for families.”
Beck and colleagues evaluated 774 children admitted to the hospital for asthma or bronchodilator-responsive wheezing to determine racial differences in pediatric readmissions with a focus on potential hardships. Fifty-seven percent were identified by caregivers as black, 33% as white, and 10% as multiracial/other; the mean age of the children was 6.2 years.
Within 12 months, 18.6% of all patients were readmitted for asthma or bronchodilator-responsive wheezing. Twenty-three percent of blacks were readmitted compared with 11% of whites; 10% of blacks were readmitted within 114 days compared with 10% of whites readmitted within 234 days (P<.01).
There was about a 40% increased likelihood of asthma readmissions among black children for financial and social hardships, such as lack of employment and not owning a car.
“There is tremendous potential for changes in clinical practice,” Robert Kahn, MD, of Cincinnati Children’s Hospital, said in a press release. “Transportation barriers might be addressed with home delivery of medications, job barriers with a connection to job training and both helped by a community health worker. The goal would be upstream, community-based prevention, rather than paying for readmissions.”
Disclosure: See the study for a full list of researchers’ financial disclosures.
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