Not So Black and White: Nursing Home Concentration of Hispanics Associated with Prevalence of Pressure Ulcers
published online 22 December 2008.
Objective
To examine the association between the nursing home (NH) concentration of Hispanics and prevalence of pressure ulcer.
Design
Secondary data analysis using data from the national repository of the 2000 Minimum Data Set (MDS) and On-Line Survey Certification and Reporting (OSCAR) data. We used a multivariate logistic model, with the Huber-White correction to account for clustering of persons within a nursing facility, to examine the association of Hispanic NH concentration with the prevalence of pressure ulcers, after adjusting for resident level characteristics.
Setting
Five states with a high population of Mexican-Americans (California, New Mexico, Arizona, Colorado, and Texas).
Participants
A total of 74,343 persons (9.26% black, 11.28% Hispanic, 79.46% non-Hispanic white) in a NH located in 1 of these 5 states during the last quarter of 2000.
Measurements
The prevalence of Stage II-IV pressure ulcers was examined in the last quarter of 2000. Stage II-IV pressure ulcers, resident demographics, and medical illness data were documented by nursing staff on the MDS.
Results
Hispanics and non-Hispanic blacks had a higher prevalence of pressure ulcers than non-Hispanic whites (7.60%, 9.71% and 12.10%, respectively). A facility's concentration of Hispanic residents was associated with prevalent pressure ulcers after adjustment for resident characteristics.
Conclusions
Residents in nursing homes in which there is a higher concentration of Hispanic residents are more likely to have a pressure ulcer.
aDepartment of Community Health, Center for Gerontology and Health Care Research, Warren Alpert School of Medicine at Brown University, Providence, RI
bDepartment of Geriatric Medicine and Gerontology, Ohio University (OU-COM), Athens, OH
Address correspondence to Michael P. Gerardo, DO, MPH, Department of Geriatric Medicine and Gerontology, Ohio University (OU-COM), Athens, Ohio 45701
This research was supported by Grants HS0001122 National Institutes of Health (NIH) National Research Service Award (NRSA) Institutional Training Grant (T32) through the Agency for Healthcare Research and Quality (AHRQ), State Policies Impact on Outcomes NIA grant R01AG020557 and CMWF20050318 Commonwealth Fund.
ABSTRACT