Public Health Reports: Age Differences in Racial/Ethnic Disparities in Preventable Hospitalizations for Heart Failure in Connecticut, 2009-2015: A Population-Based Longitudinal Study

In a recent article in Public Health Reports, Drs. Riddhi P. Doshi, Jun Yan, and Robert H. Aseltine Jr. of University of Connecticut Health Center described longitudinal trends regarding the association of race/ethnicity with preventable hospitalizations for heart failure in Connecticut and differences in disparities by age. Data on hospitalizations was analyzed for all civilian acute-care hospitals in Connecticut from 2009 through 2015. Raking methodology was used to weight the non-hospitalized population to generate a reference population representative of the state’s general population. Multivariate regression models assessed racial/ethnic disparities among adults aged 35-64, controlling for age, sex, and type of health insurance, while age and sex were controlled for adults aged 65 and older. Results indicated that after controlling for age and sex, the non-Hispanic black to non-Hispanic white odds ratio for preventable hospitalizations for heart failure ranged from 5.2-6.4 during the study period among adults aged 35-64. Among adults aged 65, non-Hispanic black adults had significantly higher odds of preventable hospitalizations than non-Hispanic white adults. Rates among Hispanic adults were significantly higher than rates among non-Hispanic adults after controlling for age and sex among adults aged 65 in 2014 and 2015. The authors concluded that the study provides information for clinical and population-based interventions targeting racial/ethnic gaps in heart failure hospitalizations. Moreover, this study shows the need for focused prevention among vulnerable populations and that raking methodology is an innovative way to eradicate selection bias in hospital discharge data.

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