Readmission Rates Higher for Blacks, Hispanics

If you are black or Hispanic and have had knee or hip replacement surgery you are 62% and 50%, respectively, more likely to be readmitted to the hospital within 30 days compared with white patients. Medicaid patients are 40% more likely to be readmitted to the hospital than are patients with private insurance.

That is the result of a study conducted by Courtland Lewis, M.D. He and his researchers analyzed five years of demographic, clinical and billing data (including race and ethnicity), from nearly 53, 000 patients admitted to Connecticut hospitals for total joint replacement (TJR) from 2008 to 2012. The patients’ average age was 67 years; 87% of the patients were white; 61% were female and 57% were covered by Medicare.

The overall 30-day readmission rate for patients was 5.2%. Postoperative infections accounted for 8% of the readmissions followed by infection and inflammatory reactions due to the internal joint prosthesis at 6% and hematoma complications during a procedure at 3%.

Lewis commented, “After controlling for two key variables implicated in race and ethnic disparities in hospital readmission—preoperative co-morbidities and the type of insurance coverage—black patients still have a 35% higher likelihood of all-cause, 30-day readmission compared with white patients. Our ongoing research in this area is focused on other factors, such as the patient’s connection to primary care and patient-provider communication, which may explain this troubling finding.