Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 4 , Pages 560-563, April 2009

Disparities in Utilization of Outpatient Rehabilitative Care Following Hip Fracture Hospitalization With Respect to Race and Ethnicity

  • Tracy U. Nguyen-Oghalai, MD

      Affiliations

    • Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
    • Corresponding Author InformationReprint requests to Tracy U. Nguyen-Oghalai, MD, Division of Rheumatology, University of Texas Medical Branch, 301 University Blvd, Route 1165, Galveston, TX 77555
    • ,
  • Kenneth J. Ottenbacher, PhD, OTR

      Affiliations

    • Division of Rehabilitation Sciences, School of Allied Health Sciences, University of Texas Medical Branch, Galveston, TX
    • ,
  • Yong-fang Kuo, PhD

      Affiliations

    • Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX
    • ,
  • Helen Wu, PhD

      Affiliations

    • Department of Obstetric and Gynecology, University of Texas Medical Branch, Galveston, TX
    • ,
  • Michael Grecula, MD

      Affiliations

    • Department of Orthopedic and Rehabilitation, University of Texas Medical Branch, Galveston, TX
    • ,
  • Karl Eschbach, PhD

      Affiliations

    • Institute for Demographic and Socioeconomic Research, College of Public Policy, University of Texas, San Antonio, TX
    • ,
  • James S. Goodwin, MD

      Affiliations

    • Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX

Abstract 

Nguyen-Oghalai TU, Ottenbacher KJ, Kuo Y-F, Wu H, Grecula M, Eschbach K, Goodwin JS. Disparities in utilization of outpatient rehabilitative care following hip fracture hospitalization with respect to race and ethnicity.

Objective

To compare the prevalence of discharge home to self-care after hip fracture hospitalization among the elderly in 3 racial groups: whites, Hispanics, and blacks.

Design

Secondary data analysis.

Setting

US hospitals.

Participants

Patients (N=34,203) aged 65 and older with Medicare insurance discharged after hip fracture hospitalization between 2001 and 2005.

Interventions

Not applicable.

Main Outcome Measure

Discharge home to self-care.

Results

Bivariate analyses showed higher rates of discharge home to self-care among minorities, 16.4% for Hispanics, 8.7% for blacks, and 5.9% for whites. Hispanics had 3-fold higher odds of being discharged home to self-care, and blacks had about 50% higher odds of being discharged home to self-care after adjusting for age, sex, Klabunde's comorbidity index, income, year of admission, type of hip fracture, surgical stabilization procedure, and length of hospital stay.

Conclusions

The higher rate of discharge home to self-care among minorities underscores the risk of suboptimal outpatient rehabilitative care among minorities with hip fracture.

Key Words: Aged, Hip Fractures, Medicare, Rehabilitation

List of Abbreviations: ADLs, activities of daily living, CI, confidence interval, ICD-9, International Classification of Diseases, 9th Revision, OR, odds ratio, SNFs, skilled nursing facilities

 

 Supported by the Building Interdisciplinary Research in Women's Health Program (grant no. K12HD052023); the National Institute of Allergy and Infectious Diseases; the National Institute of Child Health and Human Development; the Office of the Director, National Institute of Health; the Agency for Healthcare Research and Quality, Health Services Research in Under-Served Populations (grant no. R24 HS011618); National Institute on Aging, National Institutes of Health (grant no. K02 AG019736); and the National Institute of Drug Abuse (grant no. K01DA021814).

PII: S0003-9993(09)00066-5

doi:10.1016/j.apmr.2008.10.021

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 4 , Pages 560-563, April 2009

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