PROVIDENCE, R.I. [Brown University] — Nursing homes serving primarily Hispanic residents provided poorer quality care compared to facilities whose patients were mostly white, according to Brown University research. Details were published recently in the Journal of the American Medical Directors Association.
Researchers reached their conclusions after looking at the rate of bed sores at nursing homes with high concentrations of Hispanic patients, compared to others with low concentrations. Hispanics at nursing homes with a high rate of Hispanic residents were more likely to have bed sores, compared to Hispanics living in nursing homes with fewer Hispanic residents.
Michael Gerardo, adjunct assistant professor of community health at the Warren Alpert Medical School of Brown University, led the research. Two others served as co-authors — Joan Teno, M.D., professor of community health and medicine and an expert on end-of-life care, and Vincent Mor, chair of the Department of Community Health, whose work focuses on nursing home care among other areas.
Gerardo and the other professors said that more research is needed to determine the implications of their findings, directed specifically at the root cause for disparities between high-quality and low-quality nursing homes.
"A systemic evaluation of the difference in the process of care between high- and low-quality nursing homes is warranted in order to reduce nursing home disparities," Gerardo said.
Their work comes less than two years after a landmark 2007 study, published in Health Affairs, that suggests blacks are more likely than whites to live in poor-quality nursing homes. That study found that the problem was worst in the Midwest, and that inequalities in care are closely correlated to racial segregation. Mor was lead author for that study.
For the study of Hispanics in nursing homes, the researchers looked at two data sources. One, the national repository of the Minimum Data Set, is a federally mandated report of health status, function and demographics on all nursing home residents. The other, which is known as the Oscar database system, collects information on patients and nursing homes, via the Centers for Medicaid and Medicare Services.
Residents were included if they were age 65 or older, living at free-standing nursing homes in California, New Mexico, Texas, Arizona or Colorado.
Funding from the National Institutes of Health, National Institute on Aging, A National Research Service Award Institutional Training Grant and the Commonwealth Fund helped support the study.
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Journal of the American Medical Directors Association