Racial disparities in stroke functional outcomes upon discharge from inpatient rehabilitation facilities.
OBJECTIVE
Analyse racial disparities in clinical outcomes after stroke in inpatient rehabilitation facilities (IRF).


METHODS
Analyses based on data from a multi-center prospective observational cohort study on inpatient stroke rehabilitation in six IRFs from across the United States. Multivariate models examined racial disparities in functional outcomes upon discharge, taking into account patient characteristics and detailed information on processes of care.


RESULTS
In the moderate stroke group (N = 397), functional scores on admission were not significantly different between African-Americans and whites. In the severe stroke group (N = 335), whites showed significantly lower functional scores at admission [Functional Independence Measurement, (FIM)], mean scores, 44 versus 49 for African-Americans, p < 0.001). Multivariate analyses predicting discharge motor FIM score found no significant differences between African-American and white stroke patients (p = 0.2194 and p = 0.3547 in the moderate and severe stroke group, respectively).


CONCLUSIONS
Controlling for patient characteristics, therapy intensity and processes of care results in non-significant differences between African-Americans and whites in motor FIM scores upon discharge. The absence of significant differences in recovery while patients were on the rehabilitation unit suggests that racial disparities in long-term functional recovery after stroke are likely to have originated before or after the inpatient rehabilitation stay.
Department of Medical Sociology and Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium. kputman@vub.ac.be
Koen
K
Putman
Susan
S
Horn
Randall
R
Smout
Gerben
G
Dejong
Daniel
D
Deutscher
Wenqiang
W
Tian
Ching-Hui
CH
Hsieh
D000367:Age Factors; D000368:Aged; D044383:Black People; D003071:Cognition; D003920:Diabetes Mellitus / Q000453:epidemiology; D004185:Disability Evaluation; D004651:Employment; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D057187:Independent Living; D007902:Length of Stay; D008297:Male; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011446:Prospective Studies; D012720:Severity of Illness Index; D000071939:Stroke Rehabilitation; D014481:United States; D044465:White People; D001741:Black or African American