title: Disparities in postacute rehabilitation care for stroke: an analysis of the state inpatient databases.
abstract: OBJECTIVE
  To determine the extent to which sociodemographic and geographic disparities exist in the use of postacute rehabilitation care (PARC) after stroke.
  
  
  METHODS
  Cross-sectional analysis of data for 2 years (2005-2006) from the State Inpatient Databases.
  
  
  METHODS
  All short-term acute-care hospitals in 4 demographically and geographically diverse states.
  
  
  METHODS
  Individuals (age, ≥45y; mean age, 72.6y) with a primary diagnosis of stroke who survived their inpatient stay (N=187,188). The sample was 52.4% women, 79.5% white, 11.4% black, and 9.1% Hispanic.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  (1) Discharge to an institution versus home. (2) For those discharged to home, receipt of home health (HH) versus no HH care. (3) For those discharged to an institution, receipt of inpatient rehabilitation facility (IRF) or skilled nursing facility (SNF) care. Multilevel logistic regression analyses were conducted to identify sociodemographic and geographic disparities in PARC use, controlling for illness severity/comorbid conditions, hospital characteristics, and PARC supply.
  
  
  RESULTS
  Blacks, women, older individuals, and those with lower incomes were more likely to receive institutional care; Hispanics and the uninsured were less likely. Racial minorities, women, older individuals, and those with lower incomes were more likely to receive HH care; uninsured individuals were less likely. Blacks, women, older individuals, the uninsured, and those with lower incomes were more likely to receive SNF versus IRF care. PARC use varied significantly by hospital and geographic location.
  
  
  CONCLUSIONS
  Several sociodemographic and geographic disparities in PARC use were identified.
authors.affiliation: Cecil G. Sheps Center for HealthServices Research, University of North Carolina at Chapel Hill, 725 Martin Luther King Jr. Blvd., Chapel Hill, NC 27599-7590, USA. janet_freburger@unc.edu
authors.forename: Janet K
authors.initials: JK
authors.lastname: Freburger
authors.forename: George M
authors.initials: GM
authors.lastname: Holmes
authors.forename: Li-Jung E
authors.initials: LJ
authors.lastname: Ku
authors.forename: Malcolm P
authors.initials: MP
authors.lastname: Cutchin
authors.forename: Kendra
authors.initials: K
authors.lastname: Heatwole-Shank
authors.forename: Lloyd J
authors.initials: LJ
authors.lastname: Edwards
mesh_terms: D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D012307:Risk Factors; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014481:United States