6 The Hampton Roads Messenger


Volume 6 Number 9


Study: Minorities End Up Back in Hospitals More Often


BY PAUL KLEYMAN Medicare patients


at hospitals serving mainly ethnic elders end up back in the hospital within a month of being discharged much more often than patients at mainly white hospitals, according to a new study.


Hospital readmissions within 30


days of discharge—usually because a patient was released too early or without a plan for follow-up care at home—are a $17 billion-a-year problem.


The harm to patients and


enormous costs associated with these “unnecessary” or “bounce-back” readmissions led Congress to include programs and penalties aimed at reducing the problem in the Affordable Care Act, aka the health care reform law. According to a 2009 study, two out of three bounce-back readmissions stem from inadequate planning or other avoidable factors for seniors and their families.


The new study by the Harvard


School of Public Health, published in the Journal of the American Medical Association (JAMA), analyzed Medicare data for more than 3 million patients at hospitals nationwide.


The researchers compared


readmission rates for black and white patients. They also contrasted what happened to older patients who go to mainly white hospitals with those admitted to medical centers where more than one-third of the patients are minorities. The latter accounts for some 10 percent of hospitals nationwide.


“We found that white patients


at non-minority-serving hospitals consistently had the lowest odds of readmission and that black patients at minority-serving hospitals, the highest,” wrote lead author Karen E. Joynt, MD.


Overall, black patients stood a 13


percent greater chance of readmission within a month of hospital discharge, Joynt and her colleagues found.


But discrepancies persisted even


at hospitals serving mainly whites. African Americans treated at mainly white medical centers were 20 percent more likely to end up back in the hospital than whites at the same hospitals. The findings for the other conditions were similar.


About 40 percent of African-


American elders in the study were treated at mainly minority facilities, compared with only 6 percent of white Medicare patients.


Don’t Over-Penalize Black Hospitals Under the health care reform law,


Patients at largely minority


hospitals stood a 23 percent greater change of checking back in within 30 days—regardless of their race—than if they’d been in a hospital serving mainly white patients.


“The hospital at which a patient


received care appears to be at least as important as his/her race,” Joynt and her co-researchers said.


Experts have long expressed


concern about the quality of patient care at medical facilities serving largely ethnic populations. But they cautioned that hospital readmissions are only one indicator of quality care and advised patients not to react to the JAMA study by automatically avoiding such hospitals.


“Many hospitals that serve


minorities are very well managed and provide outstanding care on shoestring budgets,” said Carmen Green, MD, who directs the Healthier Black Elders Center for the Michigan Center for Urban African American Aging Research at the University of Michigan medical school. Although the new study raises important questions about minority hospitals, she said, “Don’t be scared to go to them.”


The Harvard research team focused


on Medicare patients with three common conditions: heart attacks, congestive heart failure and pneumonia.


Black patients treated for a heart


attack at minority-serving hospitals stood a 35 percent greater chance of being readmitted within a month than white patients at mainly white hospitals. White patients at minority hospitals were 23 percent more likely to be readmitted.


TowneBank Announces Special Stock Dividend


Suffolk, Va. – Hampton Roads


based TowneBank (NASDAQ: TOWN) has announced that its Board of Directors on April 25, 2012 declared a special shareholder stock dividend of 3% per common share. The dividend is payable on June 12, 2012 to shareholders of record on May 25, 2012.


Also, on April 25, 2012, the Board


of Directors declared a quarterly cash dividend of $2.00 per preferred share on its 8% Non-Cumulative Convertible Preferred Stock, Series A. The dividend is payable on June 1, 2012 to shareholders of record on May 18, 2012.


The amount and declaration of


future cash dividends are subject to Board of Director’s approval in addition to regulatory restrictions.


As one of the top community


banks in Virginia and North Carolina, TowneBank operates 26 banking offices serving Chesapeake, Hampton, Newport News, Norfolk, Portsmouth,


Suffolk, Virginia Beach, Williamsburg, James City County and York County in Virginia along with Moyock, Grandy, Camden, Southern Shores, Corolla and Kill Devil Hills in North Carolina. Towne also offers a full range of financial services through its controlled divisions and subsidiaries that include Towne Investment Group, Towne Insurance Agency, TFA Benefits, TowneBank Mortgage, TowneBank Commercial Mortgage, Prudential Towne Realty, Towne 1031 Exchange, LLC, and Corolla Classic Vacations. Through its strategic partnership with William E. Wood and Associates, the bank also offers mortgage services in all of their offices in Hampton Roads and Northeastern North Carolina. Local decision-making is a hallmark of its hometown banking strategy that is delivered through the leadership of each group’s President and Board of Directors. With total assets of $4.14 billion as of March 31, 2012, TowneBank is one of the largest banks headquartered in Virginia.


hospitals will incur fines for excessive readmissions starting in 2013.


But Joynt and her coauthors


cautioned that “minority-serving hospitals might be disproportionately affected by such penalties.”


A JAMA editorial stressed that


penalizing hospitals that treat vulnerable populations may actually deepen racial health disparities.


The editorial calls for rewarding


hospitals that reduce readmissions, while also setting aside additional funds for hospitals that shoulder the responsibility of caring for vulnerable populations and still improve over time. Simply cutting medical center budgets based on readmission rates might favor more affluent hospitals with greater resources.


America’s Future Infant Mortality


FROM PAGE 3 Hernandez-Cancio said disparities


in infant mortality rates also take a toll on minority families. While the 2010 rate for whites was 5.63 per 1,000 live births, it was 13.31 per 1,000 live births for African-Americans, 9.22 for American Indians or Alaska Natives and 7.71 for Puerto Ricans, according to the CDC.


She added that the United States


now ranks 41st globally on infant mortality: “As an advanced, wealthy nation, we are not doing well.”


Hernandez-Cancio said disparities


in chronic diseases are also a major problem with millions of dollars spent battling such diseases that have been treated improperly or, in some cases, could have been prevented. Each year, she said, health care inequities result in 100,000 premature deaths in the United States. Many are attributed to chronic diseases.


Data indicate extreme disparities


in chronic diseases, including heart disease, certain cancers, strokes, diabetes and arthritis. According to the CDC, these diseases cause seven of 10 deaths annually in America and more than 75 percent of health care costs.


Smedley says African-Ameri-


cans experience higher incidences of diabetes, high blood pressure, cancer and other chronic diseases. According to the Joint Center study, chronic diseases cost the U.S. health care system nearly $232 billion from 2003 to 2006.


Early detection, quality of care and


improving prevention management are important as it becomes clear that doing so in communities of color is crucial to curbing costs. “If we don’t get a handle on these diseases, it is going to be harder to manage the system,” Hernandez- Cancio says, adding that prevention can alleviate many costs.


Prevention: Pay Now, or Pay Later The health care reform law includes


provisions that improve financing and


delivery while also enhancing access for vulnerable populations and investing in prevention.


“Investments in prevention go


a long way in preventing racial and ethnic health inequality,” Smedley said. “About five cents of every federal health dollar is spent on prevention. Prevention works. It works to keep our population healthy and reduces health care costs.


“We pay now or pay later,” he


stated. “We’re going to be paying the price in higher health care costs, but also a population that is less healthy and unable to participate in the nation’s economic recovery.”


Racial and ethnic minorities are


much less likely than the rest of the population to have health insurance, according to the National Center on Minority Health and Health Disparities, part of the National Institutes of Health. These minorities constitute about one-third of the U.S. population but are more than half of the 50 million uninsured.


They are also overrepresented


among the 56 million people in America with inadequate access to a primary care physician. The Joint Center study found that “the combined costs of health inequalities and premature death in the United States were $1.24 trillion” from 2003 through 2006.


The cost is expected to increase.


By 2042, people of color are expected to be 50 percent of the U.S. population, signaling


significant economic


implications for minority communities. “About 47 percent of American


children under 18 are children of color,” Hernandez-Cancio said. “That really indicates this is the future of this country.”


Hernandez-Cancio concluded, “We


cannot afford not to address financial burdens and health care disparities that contribute directly to instability of our health care system. We have to tackle this problem now.”’


May 2012 The JAMA editorial states,


“The consequences of policies that inadvertently reward the rich and penalize the poor must be carefully considered.”


Toni P. Miles, M.D., of the


University of Louisville, a leading researcher on racial disparities in health care for seniors, cited research showing that “black-serving institutions basically are starved of the capital needed to provide care.”


Green urged patients—wheth-


er considering a hospital that treats mainly whites or mainly minorities—to be proactive by talking with their physicians and checking out the hospital online. One useful new resource is Hospital Compare, created by the U.S. Department of Health and Human Services, which provides information on how well a hospital cares for patients with certain medical conditions or surgical procedures.


Regardless of a hospital’s


reputation, Green added, to avoid being sent home too early or being released without an adequate plan for follow-up care at home, patients need to come prepared. This includes doing their homework on their condition and coming to the hospital with a friend or relative who can serve as their advocate, helping to ask questions and navigate through the hospital system.


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