Background: It has been detailed in the literature that a patient’s socioeconomic status (SES) may play a role in their risk of readmission for specific diseases. For instance, factors such as low income, low educational level, and Medicaid status have all been associated with significantly higher rates of readmission in patients initially admitted for congestive heart failure, severe sepsis, and total hip arthroplasty. Despite this research, there are still gaps that need to be elucidated. Our study, aims to further add to the literature on SES and readmissions and specifically fill the gap on race, language, patient perspective on future readmission, and self-reported health status.
Methods: Discharge data was obtained via the electronic health record for the general medicine service line at the study sites. Patients being discharged within 48 hours to home or home health were included for enrollment in our study. Patients were then screened for exclusion criteria including: patient unwilling to participate, or patient placed under droplet or airborne precautions. Continuous variables were compared using the student t-test. Categorical variables were compared using chi-squared analysis.
Results: 259 patients were successfully interviewed. 67 patients self-identified as Hispanic and 192 patients self-identified as Non-Hispanic. All data were statistically significant (P<0.05) unless otherwise noted. Hispanic patients were younger and had a lower level of education. Less Hispanic patients were employed for salary 4.5% vs. 14.6%, more Hispanic patients were out of work and not currently looking for work 9% vs 3.1% (P = 0.084), and less Hispanic patients were retired 29.9% vs. 42.7% (P = 0.087). Furthermore, Hispanic patients lived in larger households. Logistically, more Non-Hispanic patients stated that they have access to transportation to pick up medication post-discharge, 77.6% vs. 89.1%. Less Hispanic patients stated they had a Primary Care Physician or main doctor that they felt comfortable if they started to feel worse at home: 83.6% vs. 93.2%. Of note, Hispanic patients rated their overall health higher, viewed their doctor’s rating of their overall health higher, while stating they were more likely to be readmitted again. The socioeconomic factor that was significantly associated with readmissions was being employed for salary. Finally, Hispanic patients were found to be at a significantly higher risk of 30-day readmission, as evidenced by their higher LACE scores. However, despite having higher LACE scores, Hispanic patients were readmitted at a similar rate to non-Hispanic patients, 18.8% vs. 20.3%.