Untimely nursing care linked to racial disparities in hospital readmission among AMI patients

Gaps in nursing care due to time constraints were linked to readmissions in older African-American acute myocardial infarction patients in a new study published in Medical Care.

For the study, researchers analyzed data on more than 69,000 black and white AMI patients treated between 2006 and 2007. The data was collected from 253 hospitals across three states. Each hospital's frequency of unmet nursing care was assessed and categorized.

African-American patients, on average, exhibited more health problems and economic hardships than those of their white counterparts. They were also more likely to encounter untimely and inadequate nursing care. The 30-day readmission rate for black patients was 23.5 percent. For whites it was 18.8 percent.

"In general, older black patients were more often in hospitals where necessary care was omitted, and less often in the hospitals where care was rarely missed," said the study's lead author J. Margo Brooks-Carthon, PhD, RN, of University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy Research.

The strongest factor contributing to readmission was the untimely administration of medication. For black patients who experienced this type of unmet nursing care, the risk of readmission rose by 26 percent.

"Our findings suggest that older black AMI patients endure greater consequences when nursing tasks are left incomplete," added Dr. Brooks-Carthon

The researchers conclude, "As the nation continues to intensify efforts to reduce health disparities, solutions may lie in ensuring adequate resources to nurses working in direct care."

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