title: Disparities in Access to Outpatient Rehabilitation Therapy for African Americans with Arthritis.
abstract: Approximately, 10 million Americans have an outpatient physical therapy or occupational therapy visit per year. This population is largely Caucasian, insured, educated and middle or high income.
  
  
  
  The purpose of this study was to determine the existence of racial and/or ethnic disparities in patients with self-reported arthritis accessing office-based therapy services in the USA.
  
  
  
  A pooled analytic file of 2008-2010 data from the Medical Expenditure Panel Survey-Household Survey was created. We first conducted a descriptive analysis of the utilization of therapy services for persons reporting arthritis. From the descriptive analysis, we formulated experimental hypotheses that we tested to determine if a racial disparity existed to access therapy services between White and Asian persons with arthritis and Black/Hispanic populations. To test our hypotheses, we determined the odd ratios using a logistic regression analysis. We conducted a similar analysis controlling for education, income, and insurance status.
  
  
  
  Eight percent of the US adult population with self-reported arthritis has an office-based therapy visit each year. Hispanic and Black Americans with arthritis have a reduced odds of a therapy visit (26.5 % [95 % CI 7-42 %] and 44.8 % [95 % CI 31.9-55.3 %], respectively). We did not find a similar effect on odds of a therapy visit for the Asian American population. The effect of race/ethnicity on the odds of a therapy visit was moderated by socioeconomic variables but persists for Black Americans.
  
  
  
  The results of this study confirm a reduced likelihood of an office-based therapy visit for Black Americans with arthritis when controlled for income, insurance, and education. An effect of race/ethnicity on the likelihood of a therapy visit for Hispanic Americans with arthritis disappears when controlled for income, insurance, and education.
authors.affiliation: Department of Physical Therapy and Center for Health Services Research and Patient Safety, Creighton University, Omaha, NE, USA. robertsandstrom@creighton.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Sandstrom
authors.affiliation: Department of Physical Therapy and Center for Health Services Research and Patient Safety, Creighton University, Omaha, NE, USA.
authors.forename: Alexandria
authors.initials: A
authors.lastname: Bruns
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D001168:Arthritis / Q000208:ethnology* / Q000534:rehabilitation*; D001213:Asian / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009786:Occupational Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: Disparity; Rehabilitation therapy; Utilization