Black residents in U.S. nursing homes are much more likely than white residents to be repeatedly transferred to hospital care, a new study reports.
Black nursing home residents are likely to be transferred to the hospital and back at least four times in a given year, according to data gathered under a U.S. Centers for Medicare and Medicaid quality improvement initiative.
So are nursing home residents younger than 65, as well as those with a "full-code" lifesaving status as opposed to those who've signed a "do-not-resuscitate" order, study results showed.
The results suggest that nursing homes might not be doing all they can for certain residents to prevent hospitalization, said researcher Amy Vogelsmeier, an associate professor in the University of Missouri School of Nursing.
"For example, if a resident gets very sick and requires hospitalization, such as a blood infection from a urinary tract infection, how do we better prevent the urinary tract infection in the first place? In general, are there opportunities to better equip nursing homes with the right equipment and trained staff to better manage these conditions without the need for transfer?” Vogelsmeier said in a university news release.
Between 2017 and 2019, more than 1,400 Missouri nursing home residents were transferred to the hospital at least once a year, according to data from the Missouri Quality Initiative, an eight-year, $35-million program funded by CMS.
Among those, 113 residents were transferred at least four times or more in a year, and 17 were transferred eight or more times a year.
Besides the cost, bouncing back and forth between nursing home and hospital can put undue strain on people who are already chronically ill or frail, Vogelsmeier said.
"In addition to the financial burden and adverse health outcomes like hospital-acquired infections that can occur, transfers from a nursing home to the hospital can be traumatic, stressful and frightening for the mental health of frail adults," Vogelsmeier said.
Previous research has found Black nursing home residents who get hospitalized tend to have more chronic conditions, poorer health outcomes and live in nursing homes of poorer quality.
"Other studies suggest Black residents and their families tend to be less likely to engage in conversations about goals of care and are more likely to seek aggressive treatment, but we don't yet fully understand why that is," Vogelsmeier said.
The study was published recently in the journal BMC Health Services Research.
The U.S. National Institute on Aging has more about nursing homes.
SOURCE: University of Missouri, news release, July 1, 2022