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. 2017 Sep:72:187-194.
doi: 10.1016/j.archger.2017.06.009. Epub 2017 Jun 27.

Racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission

Donna Z Bliss  1 , Olga Gurvich  2 , Kay Savik  2 , Lynn E Eberly  3 , Susan Harms  4 , Christine Mueller  2 , Judith Garrard  5 , Kristen Cunanan  3 , Kjerstie Wiltzen  2
Affiliations

Racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission

Donna Z Bliss et al. Arch Gerontol Geriatr. 2017 Sep.

Abstract

Background: Pressure ulcers increase the risk of costly hospitalization and mortality of nursing home residents, so timely healing is important. Disparities in healthcare have been identified in the nursing home population but little is known about disparities in the healing of pressure ulcers.

Purpose: To assess racial and ethnic disparities in the healing of pressure ulcers present at nursing home admission. Multi-levels predictors, at the individual resident, nursing home, and community/Census tract level, were examined in three large data sets.

Methods: Minimum Data Set records of older individuals admitted to one of 439 nursing homes of a national, for-profit chain over three years with a stages 2-4 pressure ulcer (n=10,861) were searched to the 90-day assessment for the first record showing pressure ulcer healing. Predictors of pressure ulcer healing were analyzed for White admissions first using logistic regression. The Peters-Belson method was used to assess racial or ethnic disparities among minority group admissions.

Results: A significantly smaller proportion of Black nursing home admissions had their pressure ulcer heal than expected had they been part of the White group. There were no disparities in pressure ulcer healing disadvantaging other minority groups. Significant predictors of a nonhealing of pressure ulcer were greater deficits in activities of daily living and pressure ulcer severity.

Conclusions: Reducing disparities in pressure ulcer healing is needed for Blacks admitted to nursing homes. Knowledge of disparities in pressure ulcer healing can direct interventions aiming to achieve equity in healthcare for a growing number of minority nursing home admissions.

Keywords: Decubitus; Health disparities; Nursing homes; Pressure ulcers; Race.

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Conflict of interest statement

Conflict of interest statement

No other authors have a conflict of interest.

References

    1. Agency for Healthcare Research and Quality. 2012 National Healthcare Disparities Report. Rockville, MD: U.S. Department of Health and Human Services; 2013. (AHRQ Pub. No. 13-0003)
    1. Ahn H, Cowan L, Garvan C, Lyon D, Stechmiller J. Risk factors for pressure ulcers including suspected deep tissue injury in nursing home facility residents: analysis of national Minimum Data Set 3.0. Advances in Skin & Wound Care. 2016;29(4):178–190. doi: 10.1097/01.ASW.0000481115.78879.63. - DOI - PubMed
    1. Angel JL, Angel RJ, Aranda MP, Miles TP. Can the family still cope? Social support and health as determinants of nursing home use in the older Mexican-origin population. Journal of Aging & Health. 2004;16(3):338–354. - PubMed
    1. Baumgarten M, Margolis D, Van Doorn C, Gruber-Baldini AL, Hebel JR, Zimmerman S, Magaziner J. Black/White differences in pressure ulcer incidence in nursing home residents. Journal of the American Geriatrics Society. 2004;52(8):1293–1298. doi: 10.1111/j.1532-5415.2004.52358.x. - DOI - PubMed
    1. Bergstrom N, Horn SD, Smout RJ, Bender SA, Ferguson ML, Taler G, Voss AC. The national pressure ulcer long-term care study: Outcomes of pressure ulcer treatments in long-term care. Journal of the American Geriatrics Society. 2005;53(10):1721–1729. - PubMed