Ethnic and geographic variation in gastrostomy placement among hospitalized older patients

While whites may receive more healthcare services than African Americans, gastrostomies are more commonly placed in older African Americans. The purpose of this study was to explore geographic and ethnic variations in gastrostomy placement among older individuals. Data from National Hospital Discharge Surveys conducted between 1996 and 1999 were analyzed. The overall gastrostomy placement rate (per 1,000 discharges) in individuals aged 65 years or older during the four years was 10.9 (95% Confidence Interval [CI]: 10.3-11.5)--among African Americans 20.0 (95% CI: 17.8-22.2) and among whites 10.2 (95% CI: 9.5-10.9). According to region, placement rates per 1000 discharges were 8.9 (95% CI: 7.6-10.2) in the west and 8.5 (95% CI: 7.8-9.2) in the midwest; but 11.8 (95% CI: 10.8-12.8) in the northeast and 12.9 (95% CI: 12.0-13.9) in the south. In multivariate analyses, including sex, age, any stroke diagnosis, ethnicity (African-American and white), and region, the ethnic and regional differences persisted. The substantially higher gastrostomy placement rate among older hospitalized African Americans in the United States appears to be independent of geographical variation.