Jay J Shen1, Christopher R Cochran1, Olena Mazurenko2, Charles B Moseley1, Guogen Shan3, Robin Mukalian4, Scott Neishi1. 1. Department of Health Care Administration and Policy, University of Nevada Las Vegas. 2. Department of Health Policy and Management, Indiana University - Purdue University Indianapolis. 3. School of Community Health Sciences, University of Nevada Las Vegas. 4. Valley Health System, Las Vegas.
Abstract
OBJECTIVE: To examine the association between patient race/ethnicity, insurance status, and their interaction with patient safety indicators among hospitalized patients. METHODS: Cross-sectional study was conducted. Data were extracted from the 2009 National Inpatient Sample. A total of 3,052,268 patient safety indicator-related discharges were identified. Dependent variables were 11 patient safety indicators (PSI) whereas independent variables included race/ethnicity and insurance status. RESULTS: As compared with White patients, African American patients were more likely to experience pressure ulcer, post-operative hemorrhage or hematoma, and post-operative pulmonary embolism (PE) or deep vein thrombosis (DVE); Asian/Pacific Islander patients were more likely to experience pressure ulcer, post-operative PE or DVT, and two obstetric care PSIs; whereas Hispanic/Latino patients were more likely to experience post-operative physiometabolic derangement and accidental puncture/laceration. As compared with patients with private insurance, Medicaid patients were more likely to experience pressure ulcer, post-operative physiological metabolic derangement, post-operative PE or DVT, post-operative respiratory failure, post-operative wound dehiscence, and death among surgeries. However, both obstetric care PSIs showed that African Americans, Hispanics, and uninsured patients were less likely to incur them in comparison with their respective counterparts. Furthermore, strong interactive effects between African American and Medicaid on PSIs were detected. CONCLUSIONS: Although mixed findings in disparities in PSIs were observed in our study, Asian/Pacific Islander patients and Medicaid patients seem to be the most vulnerable. Further, interactive effects between African American and Medicaid indicate that poverty may be a key factor related to disparities in health care. Future research is merited to identify underlying factors that are related to PSIs among Asian/Pacific Islander patients. Strategies are needed to improve PSIs among Medicaid patients, especially during the current Medicaid program expansion due to the implementation of the Affordable Care Act.
OBJECTIVE: To examine the association between patient race/ethnicity, insurance status, and their interaction with patient safety indicators among hospitalized patients. METHODS: Cross-sectional study was conducted. Data were extracted from the 2009 National Inpatient Sample. A total of 3,052,268 patient safety indicator-related discharges were identified. Dependent variables were 11 patient safety indicators (PSI) whereas independent variables included race/ethnicity and insurance status. RESULTS: As compared with White patients, African American patients were more likely to experience pressure ulcer, post-operative hemorrhage or hematoma, and post-operative pulmonary embolism (PE) or deep vein thrombosis (DVE); Asian/Pacific Islander patients were more likely to experience pressure ulcer, post-operative PE or DVT, and two obstetric care PSIs; whereas Hispanic/Latino patients were more likely to experience post-operative physiometabolic derangement and accidental puncture/laceration. As compared with patients with private insurance, Medicaid patients were more likely to experience pressure ulcer, post-operative physiological metabolic derangement, post-operative PE or DVT, post-operative respiratory failure, post-operative wound dehiscence, and death among surgeries. However, both obstetric care PSIs showed that African Americans, Hispanics, and uninsured patients were less likely to incur them in comparison with their respective counterparts. Furthermore, strong interactive effects between African American and Medicaid on PSIs were detected. CONCLUSIONS: Although mixed findings in disparities in PSIs were observed in our study, Asian/Pacific Islander patients and Medicaid patients seem to be the most vulnerable. Further, interactive effects between African American and Medicaid indicate that poverty may be a key factor related to disparities in health care. Future research is merited to identify underlying factors that are related to PSIs among Asian/Pacific Islander patients. Strategies are needed to improve PSIs among Medicaid patients, especially during the current Medicaid program expansion due to the implementation of the Affordable Care Act.
Authors: M Norman Oliver; George J Stukenborg; Douglas P Wagner; Frank E Harrell; Kerry L Kilbridge; Jason A Lyman; Jonathan Einbinder; Alfred F Connors Journal: J Natl Med Assoc Date: 2004-11 Impact factor: 1.798
Authors: J G Canto; J J Allison; C I Kiefe; C Fincher; R Farmer; P Sekar; S Person; N W Weissman Journal: N Engl J Med Date: 2000-04-13 Impact factor: 91.245
Authors: Raghav Tripathi; Laura K Archibald; Rishabh S Mazmudar; Rosalynn R Z Conic; Luke D Rothermel; Jeffrey F Scott; Jeremy S Bordeaux Journal: J Am Acad Dermatol Date: 2020-04-08 Impact factor: 11.527
Authors: Sudeh Cheraghi-Sohi; Maria Panagioti; Gavin Daker-White; Sally Giles; Lisa Riste; Sue Kirk; Bie Nio Ong; Aaron Poppleton; Stephen Campbell; Caroline Sanders Journal: Int J Equity Health Date: 2020-02-12