The Relationship between Personal Demographic Components, Health Status, Discharge Status, and Mortality among Asian Pacific Islander Elders
To decrease health disparities among Asian and Pacific Islander (API) elders, the high mortality rates that they experience will need to be addressed. This is one of the first nursing studies to examine the relationships among specific variables such as personal demographic components (admission types, admission source, primary expected payer, and income level), health status (principal physical and psychiatric diagnoses), and discharge status (major diagnostic categories, LOS, and total cost of healthcare services) among API elders. The Social Determinants of Health Model provided the theoretical framework for this research.
Secondary data from the 2001 National Inpatient Sample (NIS) database (N=7,452,727) was used in this study; APIs between 65 to 75 years (n=1,520) of age were extracted from the larger (parent) study data. Descriptive statistics, Chi-square, t-test, one-way Analysis of Variance (ANOVA), and survey logistic analyses were used to analyze the data.
Findings suggest that API elders who died during hospitalization had statistically/ clinically significant longer LOS (10.5 days), were 1.05 times more likely to die, and had higher total costs of healthcare services ($57,946.5) than those who did not die during hospitalization. API elders who died during hospitalization were 5.24 times more likely to die due to acute cerebrovascular diseases and 3.11 times more likely to die because of malignant neoplasm than those who did not die during hospitalization. Others were 2.01 times more likely to die because of cancer, 1.56 times more likely to die from respiratory system diseases and 1.50 times more likely to die due to circulatory system diseases during hospitalization than those who did not die during hospitalization. Among all elders, for every step change in income level, the likelihood of death among API elders increased by 1.15 times.
Using the social determinants of health model, nurses and other health care providers could design programs that are relevant for the prevention and treatment of diseases among this diverse population of people. This study suggests that future research be implemented to address the health disparities among API elders. This process can not be effective unless the specific Asian and Pacific Islander groups are independently addressed.
School:Case Western Reserve University
School Location:USA - Ohio
Source Type:Master's Thesis
Keywords:admission types source income primary expected payer principal physical diagnoses psychiatric major diagnostic categories length of stay total cost healthcare services mortality asian pacific islanders elder
Date of Publication:01/01/2008