PROVIDENCE – Hispanics are far likelier than non-Hispanic whites to get bedsores in nursing homes, and the prevalence of bedsores is substantially higher in homes that serve large numbers of Hispanics, according to a new study by Brown University public health researchers.
The study was published recently in the Journal of the American Medical Directors Association and is the first ever to look at nursing home quality measures for Hispanics. It follows another landmark study from Brown in 2007 that found similar disparities for blacks.
In this case, Michael Gerardo, adjunct assistant professor of community health at Brown’s Warren Alpert Medical School, analyzed data for 74,343 urban nursing home residents in California, New Mexico, Colorado, Arizona and Texas, focusing on bedsore rates.
Bedsores – or pressure ulcers – are considered a good quality indicator because while some elders may be vulnerable to them because of illness and lack of mobility, nursing homes can generally keep them from becoming severe with proper precautions and treatment.
Overall, the study found that 8.2 percent of the nursing home residents had Stage II to IV pressure ulcers. But while among non-Hispanic whites the rate was 7.6 percent, for Hispanics it was 9.7 percent, and for non-Hispanic blacks, it was 12.1 percent.
Moreover, the data showed a connection between the share of Hispanics in a facility and the prevalence of bedsores, with far higher rates in facilities with 10 percent or more Hispanics.
The data did not suggest that Hispanics are treated less well than other residents at any given nursing home, Gerardo noted, but rather that they are likelier to go into homes that provide lower-quality care in general. He said the analysis suggests a need for further study of other quality indicators, such as the use of restraints and anti-psychotic medication, and at “process” measures such as nurse-to-patient ratios.
Gerardo’s study was supported by grants from the National Institutes of Health, the National Institute on Aging and the Commonwealth Fund, among others.
"The data did not suggest that Hispanics are treated less well than other residents at any given nursing home." So what's with the title? You're looking at urban nursing homes with high Medicaid populations -- Medicaid underfunds health care. Is this a surprise to these researchers?
Certainly Hispanics and Blacks are over represented in the nation's poor urban populations -- but they don't get any worse care than urban poor people of any other race. The residents and staff at any given nursing home typically reflect the community where the nursing home is located. If the residents are predominately Hispanic, they are cared for by predominantly Hispanic nursing assistants.
"The analysis suggests a need for further study of other quality indicators, such as the use of restraints and anti-psychotic medication, and at “process” measures such as nurse-to-patient ratios." Let me spare you the trouble. Each of these quality indicators will be worse in an underfunded nursing home. Look at the Medicaid rates paid to the nursing homes you study, and then look at the percentage of the nursing home's patients who are covered by Medicaid. THAT