Abstract
Horn SD, Deutscher D, Smout RJ, DeJong G, Putman K. Black-white differences in patient
characteristics, treatments, and outcomes in inpatient stroke rehabilitation.
Objective
To describe racial differences in patient characteristics, nontherapy ancillaries,
physical therapy (PT), occupational therapy (OT), and functional outcomes at discharge
in stroke rehabilitation.
Design
Multicenter prospective observational cohort study of poststroke rehabilitation.
Setting
Six U.S. inpatient rehabilitation facilities.
Participants
Black and white patients (n=732), subdivided in case-mix subgroups (CMGs): CMGs 104
to 107 for moderate strokes (n=397), and CMGs 108 to 114 for severe strokes (n= 335).
Interventions
Not applicable.
Main Outcome Measure
FIM.
Results
Significant black-white differences in multiple patient characteristics and intensity
of rehabilitation care were identified. White subjects took longer from stroke onset
to rehabilitation admission and were more ambulatory prior to stroke. Black subjects
had more diabetes. For patients with moderate stroke, black subjects were younger,
were more likely to be women, and had more hypertension and obesity with body mass
index greater than or equal to 30. For patients with severe stroke, black subjects
were less sick and had higher admission FIM scores. White subjects received more minutes
a day of OT, although black subjects had significantly longer median PT and OT session
duration. No black-white differences in unadjusted stroke rehabilitation outcomes
were found.
Conclusions
Reasons for differences in rehabilitation care between black and white subjects should
be investigated to understand clinicians' choice of treatments by race. However, we
did not find black-white differences in unadjusted stroke rehabilitation outcomes.
Key Words
List of Abbreviations:
CSI (Comprehensive Severity Index), OT (occupational therapy), PSROP (Post-Stroke Rehabilitation Outcomes Project), PT (physical therapy)To read this article in full you will need to make a payment
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Article info
Footnotes
Supported by the National Institute for Disability and Rehabilitation Research, Department of Education (grant no. H133G050153).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
