Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

Use of health care utilization as a metric of intervention success may perpetuate racial disparities: An outcome evaluation of a homeless transitional care program.

Publication ,  Journal Article
Nohria, R; Biederman, DJ; Sloane, R; Thibault, A
Published in: Public Health Nurs
November 2022

OBJECTIVE: This study explored race-based differences in disease burden, health care utilization, and mortality for Black and White persons experiencing homelessness (PEH) who were referred to a transitional care program, and health care utilization and program outcomes for program participants. DESIGN: This was a quantitative program evaluation. SAMPLE: Black and White PEH referred to a transitional care program (n = 450). We also analyzed data from the subgroup of program participants (N = 122). Of the 450 referrals, 122 participants enrolled in the program. MEASURES: We included chronic disease burden, mental illness, substance use, health care utilization, and mortality rates for all PEH referred. For program participants, we added 6-month pre/post health care utilization and program outcomes. All results were dichotomized by race. RESULTS: Black PEH who were referred to the program had higher rates of hypertension, diabetes, renal failure, and HIV and similar post-referral mortality rates compared to White PEH. Black and White PEH exhibited similar program outcomes; however, Black PEH revisited the emergency department (ED) less frequently than White PEH at 30 and 90 days after participating in the program. CONCLUSIONS: Health care utilization may be a misleading indicator of medical complexity and morbidity among Black PEH. Interventions that rely on health care utilization as an outcome measure may unintentionally contribute to racial disparities.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Public Health Nurs

DOI

EISSN

1525-1446

Publication Date

November 2022

Volume

39

Issue

6

Start / End Page

1271 / 1279

Location

United States

Related Subject Headings

  • White People
  • Transitional Care
  • Patient Acceptance of Health Care
  • Outcome Assessment, Health Care
  • Nursing
  • Ill-Housed Persons
  • Humans
  • 4206 Public health
  • 4205 Nursing
  • 1117 Public Health and Health Services
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Nohria, R., Biederman, D. J., Sloane, R., & Thibault, A. (2022). Use of health care utilization as a metric of intervention success may perpetuate racial disparities: An outcome evaluation of a homeless transitional care program. Public Health Nurs, 39(6), 1271–1279. https://doi.org/10.1111/phn.13121
Nohria, Raman, Donna J. Biederman, Richard Sloane, and Alyson Thibault. “Use of health care utilization as a metric of intervention success may perpetuate racial disparities: An outcome evaluation of a homeless transitional care program.Public Health Nurs 39, no. 6 (November 2022): 1271–79. https://doi.org/10.1111/phn.13121.
Nohria, Raman, et al. “Use of health care utilization as a metric of intervention success may perpetuate racial disparities: An outcome evaluation of a homeless transitional care program.Public Health Nurs, vol. 39, no. 6, Nov. 2022, pp. 1271–79. Pubmed, doi:10.1111/phn.13121.
Journal cover image

Published In

Public Health Nurs

DOI

EISSN

1525-1446

Publication Date

November 2022

Volume

39

Issue

6

Start / End Page

1271 / 1279

Location

United States

Related Subject Headings

  • White People
  • Transitional Care
  • Patient Acceptance of Health Care
  • Outcome Assessment, Health Care
  • Nursing
  • Ill-Housed Persons
  • Humans
  • 4206 Public health
  • 4205 Nursing
  • 1117 Public Health and Health Services