Do racial disparities exist in access to inpatient stroke rehabilitation in the state of Maryland?
OBJECTIVE
Black patients tend to have a greater number and severity of stroke cases. The literature on access to rehabilitative services shows mixed results ranging from no disparities to limited access among minority populations. This study evaluated the association of race and acute discharge to inpatient stroke rehabilitation in Maryland, a diagnostic related group-and postacute care prospective payment system-exempt state.


METHODS
Data from the Maryland Health Services and Cost Review Commission database for 2000 was used to conduct a cross sectional retrospective review to determine the rate of disposition to inpatient rehabilitation facilities (IRF). Multiple logistic regression analyses evaluated factors associated with discharge to IRF in this population.


RESULTS
There were a total of 12,208 patients hospitalized with stroke in the year 2000. Compared with urban-dwelling white patients, black patients who lived in urban dwellings were more likely to be discharged to IRF, OR 1.42, 95% CI (1.06, 1.91).


CONCLUSIONS
In the state of Maryland, urban-dwelling black stroke patients were more likely to be discharged to IRF acutely after stroke. Future studies should assess whether this trend persists in states that have larger rural populations.
Gregory
Patricia C
PC
Department of Physical Medicine and Rehabilitation, The University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599, USA.
Han
Euna
E
Morozova
Olga
O
Kuhlemeier
Keith V
KV
D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D019992:Databases as Topic; D005260:Female; D005843:Geography; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008396:Maryland; D010043:Outcome and Process Assessment, Health Care; D010351:Patient Discharge; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012923:Social Class; D012935:Social Justice; D012959:Socioeconomic Factors; D020521:Stroke / Q000208:ethnology*; D000071939:Stroke Rehabilitation; D014481:United States