Nursing Homes With More Black Residents Have Higher Health Care Utilization

Authors say a lower use of registered nurses likely drives differences in hospitalization and emergency department use.

HealthDay News Nursing homes (NHs) with the highest proportion of Black residents have the greatest number of hospitalizations and emergency department visits, according to a study published online June 12 in the Journal of the American Geriatrics Society.

Jasmine L. Travers, Ph.D., R.N., from Rory Meyers College of Nursing at New York University in New York City, and colleagues used multiple 2019 national datasets to assess the proportion of Black residents living in 14,121 NHs (i.e., none, <5%, 5 to 19.9%, 20 to 49.9%, and ≥50%). Structural NH factors, environmental factors, and health care outcomes were compared for NHs serving various proportions of Black residents.

Researchers found that compared with NHs with no Black residents, NHs with ≥50% Black residents tended to be urban, for-profit, located in the South, have more Medicaid-funded residents, and have lower ratios of registered nurse and aide hours per resident per day, as well as greater ratios of licensed practical nurse hours per resident per day. As the proportion of Black residents in an NH increased, hospitalizations and emergency visits also increased.

“As lower use of registered nurses has generally been associated with increased emergency department visits and hospitalizations of nursing home residents, it is likely that the relative scarcity of skilled workers largely drove the differences in hospitalizations and emergency department visits in nursing homes with greater proportions of Black residents,” Travers said in a statement. “Staffing is a modifiable area in which federal and state agencies should take action to eliminate disparities in quality of care among nursing homes.”

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