title: Differences in Transitional Care Provided to Mexican American and Non-Hispanic White Older Adults.
abstract: Transitional care, assisting patients to move safely through multiple health care settings, may be insufficient for older Hispanic patients.
  
  
  
  Describe home health care services referral rates for Hispanic and non-Hispanic White (NHW) patients and factors that influence case managers' (CMs') discharge planning processes.
  
  
  
  Organized by the Ethno-Cultural Gerontological Nursing Model, health records were reviewed ( n = 33,597 cases) and supplemented with qualitative description ( n = 8 CMs).
  
  
  
  Controlling for gender, insurance type, age, and hospital length of stay, NHW older adults received more home health care services referrals (odds ratio = 1.23). Insurance coverage was the most frequent determinant of CMs' post-hospital care choices, rather than patients' being Hispanic. NHW older adults were more likely to have insurance than Hispanic older adults.
  
  
  
  Insurance coverage being CMs' primary consideration in determining patients' dispositions is a form of systems-level discrimination for Hispanic vulnerable groups, which combined with other hospital-level constraints, should be addressed with policy-level interventions.
authors.affiliation: 1 The University of Arizona, Tucson, AZ, USA.
authors.forename: Janice D
authors.initials: JD
authors.lastname: Crist
authors.affiliation: 1 The University of Arizona, Tucson, AZ, USA.
authors.forename: Kari M
authors.initials: KM
authors.lastname: Koerner
authors.affiliation: 1 The University of Arizona, Tucson, AZ, USA.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Hepworth
authors.affiliation: 1 The University of Arizona, Tucson, AZ, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Pasvogel
authors.affiliation: 1 The University of Arizona, Tucson, AZ, USA.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Marshall
authors.affiliation: 1 The University of Arizona, Tucson, AZ, USA.
authors.forename: Teofila P
authors.initials: TP
authors.lastname: Cruz
authors.affiliation: 1 The University of Arizona, Tucson, AZ, USA.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Effken
mesh_terms: D000368:Aged; D005260:Female; D005853:Geriatrics / Q000592:standards* / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D036301:Qualitative Research; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D063505:Racism / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D000069341:Transitional Care / Q000592:standards* / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data
keywords: Mexican American; gerontology; health disparities; mixed-methods; think-aloud