Effect of Race/ethnicity, Insurance Status, and Area Deprivation on Hip Fracture Outcomes Among Older Adults in the United States

Abstract

This retrospective cohort study used electronic health records to explore the effect of race/ethnicity, insurance status, and area deprivation on post-discharge outcomes in older patients undergoing hip fracture surgery between 2015 and 2018 ( N = 1,150). Inverse probability of treatment weight-adjusted regression analysis was used to identify the effects of the predictors on outcomes. White patients had higher 90- and 365-day readmission risks than Black patients and higher all-period readmissions than the Other racial/ethnic (Hispanic, Asian, American Indian, and Multicultural) group ( p < .000). Black patients had a higher risk of 30- and 90-day readmission than the Other racial/ethnic group ( p < .000). Readmission risk across 1-year follow-up was generally higher among patients from less deprived areas than more deprived areas ( p < .05). The 90- and 365-day mortality risk was lower for patients from less deprived areas (vs. more deprived areas) and patients with Medicare Advantage (vs. Medicare), respectively ( p < .05). Our findings can guide efforts to identify patients for additional post-discharge support. Nevertheless, the findings regarding readmission risks contrast with previous knowledge and thus require more validation studies.