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4 Ways That Race Impacts Hospital Readmissions - And Why It Matters

Motivating patient behavior towards desirable health outcomes has long been a topic of study for healthcare industry analysts, as research suggests that better health literacy and high patient activation are key factors in reducing the likelihood of preventable hospital readmissions.

Racial disparities are a significant area of concern in this regard, as a growing body of research indicates that hospital readmission rates can be influenced by various racial and sociodemographic factors. Below are four salient examples that demonstrate the impact that racial disparities can have upon hospital readmission rates.

  1. According to a study published by the Journal of Health Care Organization, Provision and Financing, race/ethnicity and socioeconomic status were "consistently associated" with an increased probability of readmission for all five established HRRP measures (acute myocardial infarction, heart failure, pneumonia, chronic obstructive pulmonary disease, and total knee or hip arthroplasty).

  2. Low medication adherence has consistently been named as a significant variable in terms of predicting 30-day readmission rates. According to a study published by the National Institutes of Health, readmission rates among patients who demonstrated low or intermediate medication adherence hovered at roughly 20 percent, versus only a 9.3 percent readmission rate among patients who demonstrated high medication adherence. The study also found that patients in the low medication adherence group had the highest percentage of African-American individuals (31.9 percent) versus those in the intermediate and high adherence groups (21.3 percent and 15.3 percent respectively).

  3. A study conducted by researchers at the University of Rochester School of Medicine and Dentistry found that African-American patients who underwent surgery in the state of New York in 2013 were 33 percent more likely to be readmitted to the hospital than their white counterparts. The study concluded that existing Medicare Advantage plans have essentially been unsuccessful in reducing the racial disparity among surgery patients who require 30-day hospital readmission.

  4. A study cited by the National Institutes of Health found that African-American patients were more likely to be readmitted for hospitalization than white patients for a variety of diagnoses, including congestive heart failure. In addition, the same study cited research published by the Journal of the American Medical Association, which found that African-American Medicare patients had higher readmission rates after treatment for heart failure than white Medicare patients.

Improving Patient Activation: A Key to Reducing Readmission Rates

Based on criteria established by the federally mandated Hospital Readmissions Reduction Program (HRRP), hospitals can be financially penalized if their readmission rates for specific conditions exceed the national average. This can produce a deleterious effect on the revenues of safety net hospitals and other medical facilities that often serve communities with high ethnic minority populations.

If HRRP penalty costs are not reined in, it can deprive these facilities of the resources they need to serve the very populations that are most vulnerable to receiving inadequate healthcare. Risk adjustments help, but the challenge extends beyond this.

While there are obviously a multitude of factors involved in improving the quality of healthcare in socioeconomically disadvantaged areas, encouraging greater levels of patient activation and health literacy have consistently proven to be reliable steps toward improving health outcomes across virtually all demographic strata.


Tools for Increasing Patient Activation

By segmenting target audiences into groups that share common psychographic characteristics, healthcare organizations can create and deliver targeted communications that will resonate with their patients, engaging them in a way that matches their specific motivations. Psychographics pertain to people’s values, attitudes, personalities and lifestyles.  This is important, because the use of psychographics recognizes that members of a demographic or socioeconomic group do not all think and act alike, and have different priorities and communication preferences.

The PatientBond platform, for example, fosters higher levels of patient activation through its use of a proprietary psychographic segmentation model. Using carefully constructed audience profiles, PatientBond can help narrow the gap of racial disparity by enabling healthcare organizations to craft effective messages that are relevant to people's beliefs, values, attitudes, personalities, and lifestyles, all of which are factors that transcend traditional demographic or socioeconomic categories.

PatientBond has been involved with The Center for Closing the Health Gap in Cincinnati to educate underserved populations on nutrition, fitness and lifestyle modification, and to get the healthcare they need.

Using psychographic insights to personalize message delivered via text messages, emails and Interactive Voice Response, PatientBond has been able to help The Health Gap engage its constituents and motivate them to attend community education and biometric screenings.

PatientBond's robust software platform also provides healthcare organizations with a litany of highly effective cloud-based applications such as automated appointment reminders, medication adherence education, prescription refill reminders, communications promoting wellness education, customizable surveys, and much more.

By leveraging the power of platforms such as PatientBond, hospitals can more effectively connect with patients of all ethnic, racial and socioeconomic backgrounds, which can increase patient activation and reduce the likelihood of hospital readmissions across the board.

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