Severity of illness and resource use differences among white and black hospitalized elderly.
BACKGROUND
Disparities between races in access to health care services continue to exist. We examined differences in illness severity, charges, and length of stay between white and black hospitalized elderly.


METHODS
The study sample was 1184 elderly patients. Data using the Computerized Severity Index were collected for admission, maximum throughout the stay, and discharge.


RESULTS
Blacks were admitted significantly more severely ill than whites. At discharge, 96% were severity level 1. At each severity level, blacks had significantly shorter hospitalizations and lower charges. The differences were not explained by disease, surgery, age, sex, hospital, and payer.


CONCLUSIONS
Admission severity disparities may exist because of patients' decisions to seek care or provider admitting practices. We need to study whether differences in severity-adjusted resource use are due to underutilization for blacks or overutilization for whites.
Buckle
J M
JM
CIGNA Employees' Benefits Company, National Medical, Bloomfield, Conn.
Horn
S D
SD
Oates
V M
VM
Abbey
H
H
D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005249:Fees and Charges / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D012044:Regression Analysis; D012720:Severity of Illness Index; D012737:Sex Factors; D044465:White People / Q000706:statistics & numerical data