Physical and cognitive functioning among chronically ill African-American and white elderly in home care following hospital discharge

Abstract

Objectives: Although race is recognized as an important variable in health status and medical care, the conditions of African-American and white elders have not been studied sufficiently as they enter home care after hospital discharge. This study tests hypotheses that African-American elders enter home care sicker, more dependent, and cognitively impaired.

Methods: Hypotheses were tested in two independent studies, both conducted in a Midwestern city. Study 1 compares the physical and cognitive conditions of 208 African-Americans and white elders discharged home after hospitalization for congestive heart failure. Data were obtained from medical records and from patient interviews. Study 2 compares the physical and cognitive conditions of 212 African-Americans and white elders discharged home after hospitalization for hip fracture, cerebral vascular accident, and congestive heart failure. Data were obtained from medical records and interviews with patients' discharge planners.

Results: African-Americans were found to go home more sick, more dependent, and more cognitively impaired, although no race difference was found in instability at discharge.

Conclusions: These findings raise concerns about African-American elders' access to care in community settings, given their greater needs at discharge.