Relationship between state medicaid policies, nursing home racial composition, and the risk of hospitalization for black and white residents.
OBJECTIVE
To examine racial differences in the risk of hospitalization for nursing home (NH) residents.


METHODS
National NH Minimum Data Set, Medicare claims, and Online Survey Certification and Reporting data from 2000 were merged with independently collected Medicaid policy data.


METHODS
One hundred and fifty day follow-up of 516,082 long-stay residents.


RESULTS
18.5 percent of white and 24.1 percent of black residents were hospitalized. Residents in NHs with high concentrations of blacks had 20 percent higher odds (95 percent confidence interval [CI]=1.15-1.25) of hospitalization than residents in NHs with no blacks. Ten-dollar increments in Medicaid rates reduced the odds of hospitalization by 4 percent (95 percent CI=0.93-1.00) for white residents and 22 percent (95 percent CI=0.69-0.87) for black residents.


CONCLUSIONS
Our findings illustrate the effect of contextual forces on racial disparities in NH care.
Gruneir
Andrea
A
Kunin-Lunenfeld Applied Research Unit, Baycrest Centre for Geriatric Care, Toronto, ON M6A 2E1, Canada.
Miller
Susan C
SC
Feng
Zhanlian
Z
Intrator
Orna
O
Mor
Vincent
V
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005260:Female; D054625:Healthcare Disparities; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid; D009735:Nursing Homes; D011050:Policy Making; D018570:Risk Assessment; D013219:State Government; D014481:United States; D044465:White People