Racial and insurance status disparities in patient safety indicators among hospitalized patients

Jay J. Shen, Christopher R. Cochran, Olena Mazurenko, Charles B. Moseley, Guogen Shan, Robin Mukalian, Scott Neishi

Research output: Contribution to journalArticle

2 Citations (Scopus)

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, postoperative 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.

Original languageEnglish (US)
Pages (from-to)443-452
Number of pages10
JournalEthnicity and Disease
Volume26
Issue number3
DOIs
StatePublished - Jun 1 2016

Fingerprint

Insurance Coverage
Patient Safety
Medicaid
African Americans
Pressure Ulcer
Pulmonary Embolism
Hispanic Americans
Obstetrics
Healthcare Disparities
Postoperative Hemorrhage
Lacerations
Poverty
Insurance
Punctures
Venous Thrombosis
Respiratory Insufficiency
Hematoma
Inpatients

Keywords

  • Ethnicity
  • Medicaid
  • Patient Safety Indicator
  • Race
  • Socioeconomic Status
  • Uninsured

ASJC Scopus subject areas

  • Epidemiology
  • Medicine(all)

Cite this

Racial and insurance status disparities in patient safety indicators among hospitalized patients. / Shen, Jay J.; Cochran, Christopher R.; Mazurenko, Olena; Moseley, Charles B.; Shan, Guogen; Mukalian, Robin; Neishi, Scott.

In: Ethnicity and Disease, Vol. 26, No. 3, 01.06.2016, p. 443-452.

Research output: Contribution to journalArticle

Shen, Jay J. ; Cochran, Christopher R. ; Mazurenko, Olena ; Moseley, Charles B. ; Shan, Guogen ; Mukalian, Robin ; Neishi, Scott. / Racial and insurance status disparities in patient safety indicators among hospitalized patients. In: Ethnicity and Disease. 2016 ; Vol. 26, No. 3. pp. 443-452.
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