Disparities Observed Among Black Residents’ Daily Living Improvements in SNFs

Compared to other racial and ethnic groups, Black residents in skilled nursing facilities (SNFs) had significantly lower odds of improving independence in activities of daily living (ADL) after discharge from an acute hospital stay. Findings were published in the Journal of the American Geriatrics Society.

The retrospective study involved Medicare fee-for-service beneficiaries who had been treated in an acute setting for hip fracture, joint replacement, or stroke. Participants were admitted to a SNF within three days of hospital discharge from January 2013 through September 2015.

Out of a sample of 428,788 beneficiaries, 118,790 residents had hip fractures, 245,845 residents had joint replacements, and 64,153 residents had strokes. A total of 299,931 residents, or 69.9% of the sample, showed improvement in independently completing ADLs.

Using multivariable regression models, researchers evaluated improvement in ADL function among Black and Hispanic residents vs White residents.

Black residents (OR: .94; 95% CI: .91-.98) but not Hispanic residents (OR: .98; 95% CI: .94-1.03) showed “significantly lower odds” of improvement compared to White residents. Black residents also had lower odds if they had hip fracture (OR: .87; 95% CI: .80-.93) and stroke (OR: .87; 95% CI: .83-.93) but not joint replacement (OR: 1.02; 95% CI: .97-1.06).

“Improving independence in daily activities is an important outcome of postacute nursing home care,” authors noted. “Future research should investigate systemic factors that may contribute to disparities in the improvement in ADL function during a SNF stay.”

Reference:
Mathuba W, Deer R, Downer B. Racial and ethnic differences in the improvement in daily activities during a nursing home stay. J Am Geriatr Soc. 2021;1-8. doi:10.1111/jgs.17600