Online Program

Hispanic-Serving Hospitals Report More Barriers to Reducing Readmissions: Results of a National Survey of Hospital Leaders

Tuesday, November 3, 2015

Jennifer Gilbert, Massachusetts General Hospital, Boston, MA
Jose Figueroa, MD, MPH, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA
Karen Joynt, MD, MPH, Harvard Medical School, Boston, MA
Ashish Jha, MD, MPH, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA

The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals with higher-than-expected readmission rates.  Hospitals that serve minority patients have higher readmission rates than peer institutions and may face unique barriers.  Our objective was to determine whether there are differences in the barriers faced by Hispanic-serving hospitals (HSHs) in their efforts to reduce readmission rates. 


We surveyed leadership at 1600 US acute-care hospitals between January 2013 and January 2015.  We achieved a 62.5% response rate.  We defined Hispanic-serving hospitals as the top 10% of hospitals that serve the highest proportion of Hispanics and the remaining 90% as non-HSHs.  We compared responses between the groups, adjusting for non-response and sampling strategy. 


Of the 1001 respondents, 223 (22.3%) were hospital leaders at HSHs and 778 (77.7%) at non-HSHs.  HSHs reported significantly greater challenges in reducing readmissions in patient-related factors including homelessness (48.5% vs. 22.8%, p<0.0001), language barriers (42.7% vs. 11.0%, p<0.0001), lack of transportation (51.2% vs. 44.5%, p<0.0001), and mental health/substance abuse issues (74.2% vs. 69.2%, p<0.008).  HSHs were also more likely to report lack of financial resources (73.9% vs. 60.2%, p<0.0001) and staffing issues (64.2% vs. 53.8%, p<0.0001) as major challenges, as well as lack of nursing homes/rehabilitation care (22.9% vs. 19.9%, p<0.02) and lack of visiting nursing services (14.2% vs. 10.1%, p<0.002) in their communities. 


In a nationally representative survey, we found that hospitals that serve a high proportion of Hispanics report greater challenges in their efforts to reduce readmissions with regards to several patient, hospital, and community-related factors.

Learning Areas:

Administration, management, leadership
Chronic disease management and prevention
Diversity and culture
Implementation of health education strategies, interventions and programs
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
Identify the barriers disproportionately faced by Hispanic-serving hospitals. Compare the impact the Hospital Readmissions Reduction Program (HRRP) may have on hospitals that serve high populations of Hispanics with the effect it has on other hospitals. Formulate hypotheses on how the HRRP may affect hospitals that serve other populations that historically have a higher risk of readmission.

Keyword(s): Health Care Delivery, Latinos

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have managed a team of research assistants on our team's readmissions projects, checked and analyzed our data, formulated the focus on Hispanic-serving hospitals for this abstract, and wrote the abstract. My research interests include policies and programs to provide equal care for Latin Americans, as well as the effects of policies on reducing readmissions.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.