Racial Differences in Inpatient Readmission Rates and the Quality of Post-discharge Care

In this article, I add to the literature on the causes of racial disparities in hospital inpatient readmissions. One popular hypothesis that is often raised about inpatient readmissions is that race is directly correlated with readmission rates. First, I investigate whether race can directly explain the disparities in hospital readmission rates after controlling for a patient's baseline disease burden. Interestingly, I show that race (e.g.: black) is not
directly correlated with a higher probability of a readmission. Instead, the share of black patients, is correlated with higher hospital readmission levels. Both equally sick white and black patients treated by the same hospital are equally likely to be readmitted. However, hospitals with a higher share of black patients, have higher readmission rates. A potential channel that can cause high-share black hospitals to have higher readmission rates is the quality of post discharge care surrounding a hospital. I therefore analyze whether variation in the quality of post-discharge care can explain the racial disparities in hospital inpatient readmissions. Since patients self select into the types of post-discharge care, I utilize an individual fixed effect approach and all of the Medicare inpatient and skilled nursing facility claims from 2006 to 2014, to identify the effect of variation in post-discharge care quality on hospital inpatient readmission rates.