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First published on May 15, 2008
Medical Care Research and Review 2008, doi:10.1177/1077558708318283
© 2008 SAGE Publications

Article

The Effects of Race and Insurance on Potentially Avoidable Hospitalizations in Tennessee

Cyril F Chang1*, David M Mirvis2, and Teresa M Waters2

1 The University of Memphis
2 University of Tennessee Health Science Center

* To whom correspondence should be addressed. E-mail: cchang{at}memphis.edu.


  Abstract
This study examined effects of race and insurance on the risk of potentially avoidable hospitalizations (PAHs) in Tennessee. Applying the current Agency for Healthcare Research and Quality definitions for ambulatory-care-sensitive conditions to inpatient discharge data, the study found hospitalized Black patients more likely than their White counterparts to have experienced a PAH for chronic conditions. In contrast, Black inpatients’ risk was lower than that of White inpatients for acute conditions after controlling for covariates. The results also showed the strong influence of insurance coverage. Finally, an analysis of racial differences in the relative risks for PAHs using data grouped by insurance status showed that hospitalized Blacks within each subset had a greater risk of having a PAH than hospitalized Whites, although the risk varied with insurance type. The variations of PAH risks across racial and insurance categories, together with the extra risks associated with chronic conditions, deserve greater examination.


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