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Rehospitalization after childbirth more likely for black, Hispanic women

An analysis of hospital discharge data indicated ethnic and racial discrepancies in hospital readmission rates after vaginal and cesarean deliveries, according to findings published in Obstetrics & Gynecology.

Robert H. Aseltine Jr., PhD, of the division of behavioral sciences and community health at the University of Connecticut Health Center, and colleagues conducted a retrospective analysis of Connecticut's Acute Care Hospital Inpatient Discharge Database, which is maintained by the Connecticut Department of Public Health.

Researchers identified 167,857 admissions among 139,792 unique patients who delivered vaginally without complications and 75,552 admissions among 66,410 unique patients who delivered via cesarean without complications between 2005 and 2012 in Connecticut hospitals. Aseltine and colleagues reported that 30-day readmission rates per 1,000 patients were 8.8 for vaginal deliveries and 15.7 for cesarean deliveries.

Results from logistic models demonstrated rates of readmission of 12.9 per 1,000 for white women, 21.4 for Hispanic women and 28.9 for black women after cesarean delivery and rates of readmission of 7.5 per 1,000 for white women, 10.7 for Hispanic women and 14.6 for black women after vaginal delivery.

Additionally, rates of readmission were 1.25 to 1.3 times higher among those covered by Medicaid compared with those covered by private insurers.

"Although the base rates for readmission after these procedures are low relative to other conditions, the large volumes of these procedures result in a problem of significant magnitude because these are two of the most common medical and surgical procedures performed in Connecticut and nationally," Aseltine and colleagues wrote. "Were the rates observed among black women applied to the total Connecticut population, the number of readmissions after vaginal delivery would have exceeded 2,500 as opposed to 1,469 over the period of the study, making it one of the most common reasons for rehospitalization across all medical conditions."

Aseltine and colleagues noted that readmission may be linked to a lack of community resources as opposed to a lack in quality of hospital care. They also said genetic and biologic factors may factor into the differences.

"These findings should serve as a catalyst for further investigation of the interplay between patient characteristics, hospital practices, and community-based resources and insurance coverage in fostering racial and ethnic disparities in health outcomes," the researchers concluded. – by Chelsea Frajerman Pardes

Disclosures: The authors report no relevant financial disclosures.