Primary Care Engagement and Post-Hospitalization Outcomes Among Cape Verdean Adults.

Abstract

The Cape Verdean diaspora in the United States is growing, yet Cape Verdean adults remain underrepresented in health services research. We retrospectively analyzed 583 hospitalized Cape Verdean adults admitted to a tertiary care center from 2017 to 2023, and compared their post-discharge outcomes and healthcare utilization with other racial and ethnic groups. Sequential nested regression models using inverse-probability weighting assessed how demographic, clinical, and community-level characteristics using the Environmental Justice Index (EJI) mediated the observed differences. We found that Cape Verdean adults had uniquely high primary care engagement, a difference which was magnified after EJI adjustment. They also had lower rates of specialist visits and higher emergency department use, but these associations attenuated or reversed after adjustment for clinical factors and EJI. These findings suggest that care continuity is strong within this population, potentially due to robust Community Health Center engagement, but socioeconomic and structural factors may hinder specialist access and drive emergency care use.