PHYSICAL AND COGNITIVE-FUNCTIONING AMONG CHRONICALLY ILL AFRICAN-AMERICAN AND WHITE ELDERLY IN-HOME CARE FOLLOWING HOSPITAL DISCHARGE

OBJECTIVES. Although race is recognized as an important variable in he alth status and medical care, the conditions of African-American and w hite elders have not been studied sufficiently as they enter home care after hospital discharge. This study tests hypotheses that African-Am erican elders enter home care sicker, more dependent, and cognitively impaired. METHODS. Hypotheses were tested in two independent studies, both conducted in a Midwestern city. Study 1 compares the physical and cognitive conditions of 208 African-Americans and white elders discha rged home after hospitalization for congestive heart failure. Data wer e obtained from medical records and from patient interviews. Study 2 c ompares the physical and cognitive conditions of 212 African-Americans and white elders discharged home after hospitalization for hip fractu re, cerebral vascular accident, and congestive heart failure. Data wer e obtained from medical records and interviews with patients' discharg e planners. RESULTS. African-Americans were found to go home more sick , more dependent, and more cognitively impaired, although no race diff erence was found in instability at discharge. CONCLUSIONS. These findi ngs raise concerns about African-American elders' access to care in co mmunity settings, given their greater needs at discharge.