The Contribution of Chronic Conditions to Hospitalization, Skilled Nursing Facility Admission, and Death: Variation by Race

Ana R. Quiñones, Gail J. McAvay, Katherine D. Peak, Brent Vander Wyk, Heather G. Allore

Research output: Contribution to journalArticlepeer-review

Abstract

Multimorbidity (≥2 chronic conditions) is a common and important marker of aging. To better understand racial differences in multimorbidity burden and associations with important health-related outcomes, we assessed differences in the contribution of chronic conditions to hospitalization, skilled nursing facility admission, and mortality among non-Hispanic Black and non-Hispanic White older adults in the United States. We used data from a nationally representative study, the National Health and Aging Trends Study, linked to Medicare claims from 2011-2015 (n = 4,871 respondents). This analysis improved upon prior research by identifying the absolute contributions of chronic conditions using a longitudinal extension of the average attributable fraction for Black and White Medicare beneficiaries. We found that cardiovascular conditions were the greatest contributors to outcomes among White respondents, while the greatest contributor to outcomes for Black respondents was renal morbidity. This study provides important insights into racial differences in the contributions of chronic conditions to costly health-care utilization and mortality, and it prompts policy-makers to champion delivery reforms that will expand access to preventive and ongoing care for diverse Medicare beneficiaries.

Original languageEnglish (US)
Pages (from-to)2014-2025
Number of pages12
JournalAmerican journal of epidemiology
Volume191
Issue number12
DOIs
StatePublished - Nov 19 2022

Keywords

  • aging
  • attributable fraction
  • chronic disease
  • health-care utilization
  • longitudinal studies
  • mortality
  • multimorbidity
  • race/ethnicity

ASJC Scopus subject areas

  • Epidemiology

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