Racial and ethnic differences in postacute rehabilitation outcomes after stroke in the United States.
OBJECTIVE
Incidence, prevalence, and mortality for stroke vary by race and ethnicity with higher rates for blacks compared with non-Hispanic whites. Little information is available regarding differences in postacute care outcomes for racial and ethnic groups after a stroke.


METHODS
A retrospective analysis was conducted of 161,692 patients from the Uniform Data System for Medical Rehabilitation who received inpatient medical rehabilitation after a first stroke in 2002 and 2003. Multivariable models examined the effects of race and ethnicity on length of stay, functional status, rehabilitation efficiency, and discharge setting.


RESULTS
The mean age was 70.97 years (SD=12.87), 53% were female, and 76% were non-Hispanic white. Mean length of stay was similar for all groups ranging from 17.39 days (SD=10.86) to 17.93 (SD=10.59). Non-Hispanic white patients had higher admission and discharge functional status ratings compared with patients in the minority groups (P<0.01). Differences in functional status across racial/ethnic groups were related to age (F=20.49, P<0.001); the older the comparison group, the greater the difference in functional status. Non-Hispanic whites were discharged home less often than blacks (OR=0.64, 95% CI=0.62 to 0.66), Hispanics (OR=0.58, 95% CI=0.55 to 0.62), or other minority groups (OR=0.67, 95% CI=0.57 to 0.67).


CONCLUSIONS
The findings suggest racial and ethnic disparities exist in postacute care outcomes for persons with stroke.
Ottenbacher
Kenneth J
KJ
University of Texas Medical Branch, Galveston, Texas, USA. kottenba@utmb.edu
Campbell
Joanna
J
Kuo
Yong-Fang
YF
Deutsch
Anne
A
Ostir
Glenn V
GV
Granger
Carl V
CV
D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D017678:Sex Distribution; D020521:Stroke / Q000453:epidemiology / Q000208:ethnology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data