Disparities between black and white patients in functional improvement after hospitalization for an acute illness

Laura P. Sands, C. Seth Landefeld, Sandra Moody Ayers, Kristine Yaffe, Robert Palmer, Richard Fortinsky, Steven Counsell, Kenneth E. Covinsky

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

The aim of this study was to determine whether older black and white patients experience different rates of improvement in functioning after being acutely hospitalized. Of the 2,364 community-living patients in this prospective cohort study, 25% self-reported their race/ethnicity to be black. The outcomes were improvement in basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) from admission to discharge and 90 days postdischarge. Multivariable models that included statistical adjustment for age, illness severity, in-hospital social service referral, dementia, admission level of functioning, and change in functioning from 2 weeks before admission were computed to determine whether black and white patients experienced significantly different rates of recovery at discharge and 90 days after discharge in ADL and IADL functioning. Black patients were as likely as white patients to improve in ADL functioning by discharge (odds ratio (OR) = 0.97, 95% confidence interval (CI) = 0.76-1.24) or by 90 days after discharge (OR = 0.95, 95% CI = 0.73-1.24) but significantly less likely to improve IADL functioning by discharge (OR = 0.72, 95% CI = 0.56-0.93) or by 90 days after discharge (OR = 0.68, 95% CI = 0.51-0.90). The findings suggest that differential rates of recovery in functioning after an acute hospitalization may contribute to racial/ethnic disparities in IADL functioning, which has implications for the setting of future interventions oriented toward reducing these disparities.

Original languageEnglish
Pages (from-to)1811-1816
Number of pages6
JournalJournal of the American Geriatrics Society
Volume53
Issue number10
DOIs
StatePublished - Oct 2005

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Activities of Daily Living
Hospitalization
Odds Ratio
Confidence Intervals
hydroquinone
Statistical Models
Social Work
Dementia
Cohort Studies
Referral and Consultation
Prospective Studies

Keywords

  • Acute illness
  • Disparities
  • Functioning

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Disparities between black and white patients in functional improvement after hospitalization for an acute illness. / Sands, Laura P.; Landefeld, C. Seth; Ayers, Sandra Moody; Yaffe, Kristine; Palmer, Robert; Fortinsky, Richard; Counsell, Steven; Covinsky, Kenneth E.

In: Journal of the American Geriatrics Society, Vol. 53, No. 10, 10.2005, p. 1811-1816.

Research output: Contribution to journalArticle

Sands, Laura P. ; Landefeld, C. Seth ; Ayers, Sandra Moody ; Yaffe, Kristine ; Palmer, Robert ; Fortinsky, Richard ; Counsell, Steven ; Covinsky, Kenneth E. / Disparities between black and white patients in functional improvement after hospitalization for an acute illness. In: Journal of the American Geriatrics Society. 2005 ; Vol. 53, No. 10. pp. 1811-1816.
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