Purpose: There is a lack of research focused on understanding the differences in the healthcare utilization of lung cancer patients between ethnic groups. This study aims to characterize disparities in healthcare utilization for Hispanic lung cancer patients compared to non-Hispanic patients. Methods: National Inpatient Sample was used to identify nationwide lung cancer patients (n=141,675, weighted n=702,878) from 2010 to 2014. We examined the characteristics of the study sample by race (Hispanic vs non-Hispanic) and its association with healthcare utilization, measured by discounted hospital charges and length of stay. Multivariate survey regression models were used to identify predictors by racial groups. Results: Among 702,878 lung cancer patients, 5.1% were Hispanic. Descriptive statistics showed that Hispanics have higher hospital charges and length of stay. Survey regression results also suggested that Hispanic lung cancer patients were associated with higher hospital charges (26.6%) and length of stay (3.5%) than non-Hispanic lung cancer patients. Subgroup analysis displayed a similar trend to the full model. Conclusion: Healthcare utilization disparities may exist for lung cancer Hispanic patients due to insurance status and early detection. Thus, our findings support providing financial assistance and targeted programs for minority patients. Future health policy consideration should be given to those vulnerable populations where limited healthcare resources are available.

This study explores factors associated with the breadth (extent) and depth (level of detail) of digital information exchange among stakeholders in health information technology (IT) systems. Annual and IT surveys of the American Hospital Association and the U.S. Census Bureau’s small-area income and poverty estimates from 2014–2016 were analyzed for associations between key factors and breadth and depth of information exchange. OLS Regression was used with a sample consisting of 10,040 year-hospital observations. We found that hospital-level variables such as size, ownership type, system affiliation, physician-hospital arrangement, and revenue model affect information exchange. We further found that market-level variables such as concentration ratio, urbanness, and median household income, although they directly affect information exchange, do not moderate the relationship between hospital-level variables and information exchange. Our study fills a gap in the previous literature arising from the lack of research on the determinants of health information exchange.

Purpose: Previous literature has limited empirical evidence describing the association between border location and readmission rates among hospitals in the U.S.-Mexico border region. Thus, our study explores this novel connection in Texas border hospitals using a non-experimental longitudinal study design. Materials and Methods: Using longitudinal panel data (2013∼ 2016) drawn from the American Hospital Association Annual Survey Database, Hospital Compare, and Area Health Resource File, a random-effects linear regression analysis was performed to quantify the impact of border location on the readmission rates of the same sample at multiple timed points. Results: We found a positive relationship between border location and 30-day hospital readmission rates for heart failure and pneumonia in Texas. Border hospitals in Texas had approximately a 4.17% higher heart failure readmission rate and a 3.46% higher pneumonia readmission rate than non-border hospitals. We also identified several hospital organizational and market factors associated (eg, registered nurse [RN]-to-patient ratio) with hospital readmission rates. Conclusion: The results suggest that improving RN staffing levels can be the most feasible action to lower the readmission rates among border Texas hospitals. Decreasing readmission rates by increasing RN staffing levels would also help them avoid reimbursement reduction under the Hospital Readmission Reduction Program (HRRP) and enhance overall health in Texas border communities. Further, to improve border health in Texas, decision-makers in state and local governments must consider incentivizing border hospitals to improve RN staffing levels and modulating the market factors affecting hospital readmission rates that are mostly beyond the control of hospitals.