Proctor E K, Morrow-Howell N, Chadiha L, Braverman A C, Darkwa O, Dore P
Jane Addams College of Social Work, University of Illinois at Chicago, USA.
Med Care. 1997 Aug;35(8):782-91. doi: 10.1097/00005650-199708000-00004.
Although race is recognized as an important variable in health status and medical care, the conditions of African-American and white elders have not been studied sufficiently as they enter home care after hospital discharge. This study tests hypotheses that African-American elders enter home care sicker, more dependent, and cognitively impaired.
Hypotheses were tested in two independent studies, both conducted in a Midwestern city. Study 1 compares the physical and cognitive conditions of 208 African-Americans and white elders discharged home after hospitalization for congestive heart failure. Data were obtained from medical records and from patient interviews. Study 2 compares the physical and cognitive conditions of 212 African-Americans and white elders discharged home after hospitalization for hip fracture, cerebral vascular accident, and congestive heart failure. Data were obtained from medical records and interviews with patients' discharge planners.
African-Americans were found to go home more sick, more dependent, and more cognitively impaired, although no race difference was found in instability at discharge.
These findings raise concerns about African-American elders' access to care in community settings, given their greater needs at discharge.
尽管种族被认为是健康状况和医疗护理中的一个重要变量，但非裔美国老年人和白人老年人出院后进入家庭护理时的情况尚未得到充分研究。本研究检验了以下假设：非裔美国老年人进入家庭护理时病情更严重、依赖性更强且存在认知障碍。
在中西部一个城市进行的两项独立研究中对假设进行了检验。研究1比较了208名因充血性心力衰竭住院后出院回家的非裔美国老年人和白人老年人的身体和认知状况。数据来自医疗记录和患者访谈。研究2比较了212名因髋部骨折、脑血管意外和充血性心力衰竭住院后出院回家的非裔美国老年人和白人老年人的身体和认知状况。数据来自医疗记录以及与患者出院计划制定者的访谈。
发现非裔美国老年人回家时病情更严重、依赖性更强且认知障碍更严重，尽管出院时的不稳定情况未发现种族差异。
鉴于非裔美国老年人出院时需求更大，这些发现引发了对他们在社区环境中获得护理的担忧。
