Gender and ethnic differences in rehabilitation outcomes after hip-replacement surgery.
OBJECTIVE
To examine gender and ethnic differences in functional status and living setting for patients after hip arthroplasty.


METHODS
Retrospective cohort study of 69,793 patients receiving inpatient medical rehabilitation after hip arthroplasty included in the Uniform Data System for Medical Rehabilitation database for the period of 2002-2003. Primary measures included functional status as assessed by the FIM instrument and discharge living setting (home vs. not home). The sample included non-Hispanic white, non-Hispanic black, Hispanic, and Asian patients.


RESULTS
Multivariate regression models showed the greatest FIM instrument change scores from admission to discharge among non-Hispanic whites (mean [SE]: 23.42 [0.18]) and among women (mean [SE]: 22.79 [0.23]). Asians had the lowest mean change scores (mean [SE]: 22.00 [0.53]). Estimates from multivariate logistic models showed that being of nonwhite ethnicity was associated with higher odds of home discharge (black: OR [CI]: 1.23, CI 95% = 1.07, 1.41; Hispanic: OR [CI]: 1.51, CI 95% = 1.15-1.99). Compared with women, men had higher odds of home discharge (OR [CI]: 1.08, CI 95% = 1.01, 1.17).


CONCLUSIONS
The findings suggest that ethnic and gender disparities exist in postacute care outcomes for persons with hip arthroplasty.
Sealy Center on Aging, University of Texas Medical Branch at Galveston, Galveston, Texas 77555-0460, USA.
Ivonne-Marie
IM
Bergés
Yong-Fang
YF
Kuo
Glenn V
GV
Ostir
Carl V
CV
Granger
James E
JE
Graham
Kenneth J
KJ
Ottenbacher
D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects / Q000534:rehabilitation*; D005260:Female; D006304:Health Status; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011184:Postoperative Period; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012737:Sex Factors; D013781:Texas; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*