Racial Disparities in Preventable Adverse Events Attributed to Poor Care Coordination Reported in a National Study of Older US Adults.

ABSTRACT

BACKGROUND: Previous work found that Black patients experience worse care coordination than White patients. OBJECTIVE: The aim was to determine if there are racial disparities in self-reported adverse events that could have been prevented with better communication. RESEARCH DESIGN: We used data from a cross-sectional survey that was administered to participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study in 2017-2018. SUBJECTS: REGARDS participants aged 65+ years of age who reported >1 ambulatory visits and >1 provider in the prior 12 months (thus at risk for gaps in care coordination). MEASURES: Our primary outcome was any repeat test, drug-drug interaction, or emergency department visit or hospitalization that respondents thought could have been prevented with better communication. We used Poisson models with robust standard error to determine if there were differences in preventable events by race. RESULTS: Among 7568 REGARDS respondents, the mean age was 77 years (SD 6.7), 55.4% were female, and 33.6% were Black. Black participants were significantly more likely to report any preventable adverse events compared with Whites [adjusted risk ratio (aRR) 1.64; 95% confidence interval (CI) 1.42-1.89]. Specifically, Blacks were more likely than Whites to report a repeat test (aRR 1.77; 95% CI 1.38-2.29), a drug-drug interaction (aRR 1.76; 95% CI 1.46-2.12), and an emergency department visit or hospitalization (aRR 1.45; 95% CI 1.01-2.08). CONCLUSIONS: Black participants were significantly more likely to report a preventable adverse event attributable to poor care coordination than White participants, independent of demographic and clinical characteristics.