Journal of the American Geriatrics Society

Volume 53, Issue 10 p. 1811-1816

Disparities Between Black and White Patients in Functional Improvement After Hospitalization for an Acute Illness

Laura P. Sands PhD,

Laura P. Sands PhD

From the ^* School of Nursing, Purdue University, West Lafayette, Indiana ^† Center on Aging and the Life Course ^‡ UCSF/Mt. Zion Center on Aging ^§ Division of Geriatrics, Department of Medicine, Departments of ^∥ Psychiatry, ^¶ Neurology, and ^# Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California ^# Veterans Affairs Medical Center, San Francisco, California ^†† Division of Geriatrics, Cleveland Clinic Foundation, Cleveland, Ohio ^‡‡ Center on Aging and Division of Geriatrics, Farmington, Connecticut University of Connecticut Health Center ^§§ Center for Aging Research, Indiana University, Indianapolis, Indiana.

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C. Seth Landefeld MD,

C. Seth Landefeld MD

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Sandra Moody Ayers MD,

Sandra Moody Ayers MD

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Kristine Yaffe MD,

Kristine Yaffe MD

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Robert Palmer MD,

Robert Palmer MD

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Richard Fortinsky PhD,

Richard Fortinsky PhD

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Steven R. Counsell MD,

Steven R. Counsell MD

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Kenneth E. Covinsky MD, MPH,

Kenneth E. Covinsky MD, MPH

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Laura P. Sands PhD,

Laura P. Sands PhD

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C. Seth Landefeld MD,

C. Seth Landefeld MD

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Sandra Moody Ayers MD,

Sandra Moody Ayers MD

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Kristine Yaffe MD,

Kristine Yaffe MD

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Robert Palmer MD,

Robert Palmer MD

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Richard Fortinsky PhD,

Richard Fortinsky PhD

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Steven R. Counsell MD,

Steven R. Counsell MD

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Kenneth E. Covinsky MD, MPH,

Kenneth E. Covinsky MD, MPH

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First published: 21 September 2005

https://doi.org/10.1111/j.1532-5415.2005.53517.x

Citations: 18

Address correspondence to Laura P. Sands, PhD, Purdue University, 502 North University Street, West Lafayette, IN 47907. E-mail: [email protected]

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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.

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Volume53, Issue10

October 2005

Pages 1811-1816

Disparities Between Black and White Patients in Functional Improvement After Hospitalization for an Acute Illness

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Disparities Between Black and White Patients in Functional Improvement After Hospitalization for an Acute Illness

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