ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2019
Quality of Post-Acute Care in Skilled Nursing Facilities That Disproportionately Serve Black and Hispanic Patients.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Post-Acute Care Trends and Disparities After Joint Replacements in the United States, 1991-2018: A Systematic Review.Journal of the American Medical Directors Association · 2024Pooled it
- Connect-Home transitional care from skilled nursing facilities to home: A stepped wedge, cluster randomized trial.Journal of the American Geriatrics Society · 2023Trial
- Associations between Social Determinants of Health and Posthospitalization Rehabilitation among Critically Ill Older Adults.Annals of the American Thoracic Society · 2026Observational
- Changes in Patient Medical Complexity After Skilled Nursing Facility Payment Reform: A Qualitative Study.Journal of the American Medical Directors Association · 2026Article
- A Research Agenda to Mitigate Racial and Ethnic Disparities in U.S. Critical Care Medicine: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Penalties in 2024 in Medicare's Skilled Nursing Facility Value-Based Purchasing Program.Journal of the American Geriatrics Society · 2025Article
- Methods for studying health disparities in U.S. nursing homes: a scoping review.BMC health services research · 2025Article
- Living with chronic structural vulnerability: A biopsychosocial-structural formulation of a patient exhibiting "medical noncompliance" in the setting of historical trauma and social suffering.Journal of substance use and addiction treatment · 2025Article
- Factors Associated With the Ability of US Nursing Homes to Accept Residents With Severe Obesity.Journal of the American Medical Directors Association · 2024Article
- Access to preferred skilled nursing facilities: Transitional care pathways for patients with Alzheimer's disease and related dementias.Health services research · 2024Article
- Using Human-Centered Design Tools to Improve Health Justice.Journal of graduate medical education · 2024Article
- Severe neighborhood deprivation and nursing home staffing in the United States.Journal of the American Geriatrics Society · 2023Article
- Characteristics, utilization, and concentration of outpatient care for dual-eligible Medicare beneficiaries.The American journal of managed care · 2022Article
- Repeat hospital transfers among long stay nursing home residents: a mixed methods analysis of age, race, code status and clinical complexity.BMC health services research · 2022Article
- Risk Factors of Skilled Nursing Facility Admissions and the Interrelation With Hospitalization and Amount of Informal Caregiving Received.Medical care · 2022Observational
- Racial and ethnic differences in the improvement in daily activities during a nursing home stay.Journal of the American Geriatrics Society · 2022Article
- COVID-19 Survival and its impact on chronic kidney disease.Translational research : the journal of laboratory and clinical medicine · 2022Review
- Quality of Care and Outcomes Among a Diverse Group of Long-Term Care Residents With Alzheimer's Disease and Related Dementias.Journal of aging and health · 2022Article
- Healthcare utilization and costs among high-need and frail Mexican American Medicare beneficiaries.PloS one · 2022Article
- Shifting US Patterns of COVID-19 Mortality by Race and Ethnicity From June-December 2020.Journal of the American Medical Directors Association · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundUnderstanding and addressing racial and ethnic disparities in the quality of post-acute care in skilled nursing facilities is an important health policy issue, particularly as the Medicare program initiates value-based payments for these institutions.
methodsOur final cohort included 649,187 Medicare beneficiaries in either the fee-for-service or Medicare Advantage programs, who were 65 and older and were admitted to a skilled nursing facility following an acute hospital stay, from 8,375 skilled nursing facilities. We examined the quality of care in skilled nursing facilities that disproportionately serve minority patients compared to non-Hispanic whites. Three measures, all calculated at the level of the facility, were used to assess quality of care in skilled nursing facilities: (a) 30-day rehospitalization rate; (b) successful discharge from the facility to the community; and (c) Medicare five-star quality ratings.
resultsWe found that African American post-acute patients are highly concentrated in a small number of institutions, with 28% of facilities accounting for 80% of all post-acute admissions for African American patients. Similarly, just 20% of facilities accounted for 80% of all admissions for Hispanics. Skilled nursing facilities with higher fractions of African American patients had worse performance for three publicly reported quality measures: rehospitalization, successful discharge to the community, and the star rating indicator.
conclusionsEfforts to address disparities should focus attention on institutions that disproportionately serve minority patients and monitor unintended consequences of value-based payments to skilled nursing facilities.
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