Featured Research

from universities, journals, and other organizations

Higher prevalence of pressure ulcers among black high-risk nursing home residents is related to site of care, study finds

Date:
July 12, 2011
Source:
JAMA and Archives Journals
Summary:
Among nursing home residents at high risk for pressure ulcers, black residents had higher prevalence rates than white residents from 2003 through 2008, with the disparity largely related to the higher rates among nursing homes that disproportionately serve black residents, according to a new study.

Among nursing home residents at high risk for pressure ulcers, black residents had higher prevalence rates than white residents from 2003 through 2008, with the disparity largely related to the higher rates among nursing homes that disproportionately serve black residents, according to a study in the July 13 issue of JAMA.

"Pressure ulcers are a common health problem among nursing home residents and substantially increase morbidity, mortality, and the cost of care," the authors write. "A variety of nursing home quality improvement programs have been implemented during the last decade but their implications for racial disparities on quality are unknown."

Yue Li, Ph.D., of the University of Iowa, Iowa City, and colleagues analyzed the trend of pressure ulcer prevalence in nursing homes by race and site of care from 2003 through 2008. The study included data on pressure ulcer rates in 2.1 million white and 346,808 black residents of 12,473 certified nursing homes in the United States who were considered at high risk of developing pressure ulcers. Nursing homes were categorized according to their proportions of black residents.

The researchers found that pressure ulcer rates decreased overall from 2003 through 2008 among high-risk residents of nursing homes, but black residents showed persistently higher pressure ulcer rates than white residents. The pressure ulcer rate among black residents decreased from 16.8 percent in 2003 to 14.6 percent in 2008 and the rate among white residents decreased from 11.4 percent in 2003 to 9.6 percent in 2008. Despite the lowered pressure ulcer rates over time for both races, racial disparity remained relatively unchanged.

Analysis indicated that more than half of the risk-adjusted disparity between black and white residents in pressure ulcer rates for each year was found between sites rather than within sites of care. Black residents in the nursing home facilities with the highest concentrations of black residents had the highest pressure ulcer rate (15.5 percent in 2008), which was about 7 percent higher than the rate for white residents in facilities with lowest concentrations of black residents (8.8 percent in 2008), which was the lowest among all groups. Residents of both races and in nursing homes with the highest concentrations of blacks had at least a 30 percent increased risk-adjusted odds of pressure ulcers compared with residents in nursing homes caring for none or only a small percentage of black residents.

Nursing home facilities with higher concentrations of black residents had higher rates of pressure ulcers for both black and white residents compared with nursing homes with lower concentrations of black residents. Nursing homes with higher concentrations of black residents tended to have lower staffing levels of registered nurses and certified nurse assistants and to be larger for-profit and urban facilities. "These facilities may be more financially disadvantaged when caring for patients predominantly receiving Medicaid," the authors write.

"Given the widespread racial disparities in nursing home care, it is imperative to close the gap beyond industry-wide improvements. The first key step would be understanding why these disparities exist before appropriate efforts can be made to eliminate them. Given that nursing home care for minority residents is concentrated among a small number of nursing homes, understanding how outcomes vary as a function of site of care can inform targeted interventions," the researchers write.

The authors add that their findings suggest several policy implications. "Importantly, future quality initiatives such as the renewed Centers for Medicare & Medicaid Services quality improvement organization program could consider incorporating disparity-eliminating efforts."

Editorial: Racial Disparities in Rates of Pressure Ulcers in Nursing Homes and Site of Care

Nancy Bergstrom, Ph.D., R.N., of the University of Texas Health Science Center, Houston, and Susan D. Horn, Ph.D., of the International Severity Information Systems, Salt Lake City, comment on the findings of this study in an accompanying editorial. Among other points, the authors raise the issue that databases should include information on new, or incident pressure ulcers, rather than just the existence of a pressure ulcer because otherwise a resident admitted from a hospital with a preexisting pressure ulcer appears in the nursing home's pressure ulcer rates.

"Additional research is needed to accurately identify the causes of black and white differences in the incidence of pressure ulcers in nursing facilities. Individual characteristics, staffing, and system changes such as mattresses and disposable briefs can all affect pressure ulcer risk and rates and help explain disparities. Establishing the causative factors in pressure ulcer rates will be important to help to ensure that all nursing facility residents receive appropriate care."


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal References:

  1. Y. Li, J. Yin, X. Cai, J. Temkin-Greener, D. B. Mukamel. Association of Race and Sites of Care With Pressure Ulcers in High-Risk Nursing Home Residents. JAMA: The Journal of the American Medical Association, 2011; 306 (2): 179 DOI: 10.1001/jama.2011.942
  2. N. Bergstrom, S. D. Horn. Racial Disparities in Rates of Pressure Ulcers in Nursing Homes and Site of Care. JAMA: The Journal of the American Medical Association, 2011; 306 (2): 211 DOI: 10.1001/jama.2011.961

Cite This Page:

JAMA and Archives Journals. "Higher prevalence of pressure ulcers among black high-risk nursing home residents is related to site of care, study finds." ScienceDaily. ScienceDaily, 12 July 2011. <www.sciencedaily.com/releases/2011/07/110712162824.htm>.
JAMA and Archives Journals. (2011, July 12). Higher prevalence of pressure ulcers among black high-risk nursing home residents is related to site of care, study finds. ScienceDaily. Retrieved April 17, 2014 from www.sciencedaily.com/releases/2011/07/110712162824.htm
JAMA and Archives Journals. "Higher prevalence of pressure ulcers among black high-risk nursing home residents is related to site of care, study finds." ScienceDaily. www.sciencedaily.com/releases/2011/07/110712162824.htm (accessed April 17, 2014).

Share This



More Health & Medicine News

Thursday, April 17, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Could Even Casual Marijuana Use Alter Your Brain?

Could Even Casual Marijuana Use Alter Your Brain?

Newsy (Apr. 16, 2014) A new study conducted by researchers at Northwestern and Harvard suggests even casual marijuana use can alter your brain. Video provided by Newsy
Powered by NewsLook.com
Thousands Of Vials Of SARS Virus Go Missing

Thousands Of Vials Of SARS Virus Go Missing

Newsy (Apr. 16, 2014) A research institute in Paris somehow misplaced more than 2,000 vials of the deadly SARS virus. Video provided by Newsy
Powered by NewsLook.com
Formerly Conjoined Twins Released From Dallas Hospital

Formerly Conjoined Twins Released From Dallas Hospital

Newsy (Apr. 16, 2014) Conjoined twins Emmett and Owen Ezell were separated by doctors in August. Now, nearly nine months later, they're being released from the hospital. Video provided by Newsy
Powered by NewsLook.com
Ebola Outbreak Now Linked To 121 Deaths

Ebola Outbreak Now Linked To 121 Deaths

Newsy (Apr. 15, 2014) The ebola virus outbreak in West Africa is now linked to 121 deaths. Health officials fear the virus will continue to spread in urban areas. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins