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May 18, 2011

Race, Site of Care, and Hospital Readmission Rates

JAMA. 2011;305(19):1965-1966. doi:10.1001/jama.2011.640

To the Editor: The study by Dr Joynt and colleagues using national Medicare data demonstrated that black patients were more likely than white patients to be readmitted within 30 days after hospitalization.1 Recently, Allaudeen et al2 published a retrospective observational study in an urban tertiary hospital also identifying black race as a high risk factor for readmission. Although the patient populations were different, the former being elderly Medicare patients from multiple medical centers and the latter being patients with a wide range of ages from a single medical center, the result is important for ongoing readmission prevention interventions. Unfortunately, neither of the studies had any information regarding the literacy level and socioeconomic status (SES) of the patients. The study by Joynt et al showed that a higher proportion of black patients were Medicaid eligible, suggesting low income in this population. Rather than black race alone, multiple factors such as living conditions, low income, low health literacy, and availability of primary care physicians may be causes of high readmission rates. Further studies are needed to examine the association between SES and readmission rates in black patients.