Disparities in Utilization of Outpatient Rehabilitative Care Following Hip Fracture Hospitalization With Respect to Race and Ethnicity
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.
aDepartment of Internal Medicine, University of Texas Medical Branch, Galveston, TX
bDivision of Rehabilitation Sciences, School of Allied Health Sciences, University of Texas Medical Branch, Galveston, TX
cDepartment of Obstetric and Gynecology, University of Texas Medical Branch, Galveston, TX
dDepartment of Orthopedic and Rehabilitation, University of Texas Medical Branch, Galveston, TX
eInstitute for Demographic and Socioeconomic Research, College of Public Policy, University of Texas, San Antonio, TX
Reprint requests to Tracy U. Nguyen-Oghalai, MD, Division of Rheumatology, University of Texas Medical Branch, 301 University Blvd, Route 1165, Galveston, TX 77555
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).
ABSTRACT