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August 1992

Severity of Illness and Resource Use Differences Among White and Black Hospitalized Elderly

Author Affiliations

From the CIGNA Employees' Benefits Company, National Medical, Bloomfield, Conn (Dr Buckle); and Departments of Health Policy and Management (Dr Horn and Ms Oates) and Biostatistics (Dr Abbey), School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Md.

Arch Intern Med. 1992;152(8):1596-1603. doi:10.1001/archinte.1992.00400200034007

Background.—  Disparities between races in access to health care services continue to exist. We examined differences in illness severity, charges, and length of stay between white and black hospitalized elderly.

Methods.—  The study sample was 1184 elderly patients. Data using the Computerized Severity Index were collected for admission, maximum throughout the stay, and discharge.

Results.—  Blacks were admitted significantly more severely ill than whites. At discharge, 96% were severity level 1. At each severity level, blacks had significantly shorter hospitalizations and lower charges. The differences were not explained by disease, surgery, age, sex, hospital, and payer.

Conclusions.—  Admission severity disparities may exist because of patients' decisions to seek care or provider admitting practices. We need to study whether differences in severity-adjusted resource use are due to underutilization for blacks or overutilization for whites.(Arch Intern Med. 1992;152:1596-1603)