Blacks and Hispanics are less likely to receive outpatient rehabilitation after hip fractures
Hip fractures can be debilitating, particularly since more than 90 percent of them occur in persons aged 65 and older. In order for patients to regain their mobility, rehabilitation after hospital discharge is critical. Racial disparities in functioning after hip fracture may be due in part to the higher rate of discharge home for self-care among blacks and Hispanics compared with whites, suggests a new study.
Texas researchers examined the posthospital care of 34,203 patients hospitalized for hip fracture between 2001 and 2005. All were aged 65 or older (mostly women) and on Medicare. The racial breakdown was 95.3 percent whites, 3.5 percent blacks, and 1.3 percent Hispanics. The majority of patients (60.1 percent) were discharged to a skilled nursing facility or inpatient rehabilitation facility (23.5 percent). Fewer patients were discharged home to a home health care organization or outpatient therapy (5.8 percent), home to self-care (6.2), or other environment (4.4 percent). Hispanics were nearly three times as likely to be discharged home to self-care as whites (16.4 vs. 5.9 percent). Blacks had nearly 50 percent higher odds of being discharged home to self-care than whites (8.7 vs. 5.9 percent).
The researchers offer some possible explanations as to why these higher rates of discharge home occur among minorities. First, minorities tend to have larger families with younger members who can care for older relatives. Also, minorities tend to have less favorable perceptions of rehabilitation facilities than do the family members of white patients. The study was supported in part by the Agency for Healthcare Research and Quality (HS11618).
See "Disparities in utilization of outpatient rehabilitative care following hip fracture hospitalization with respect to race and ethnicity," by Tracy U. Nguyen-Oghalai, M.D., Kenneth J. Ottenbacher, Ph.D., O.T.R., Young-fang Kuo, Ph.D., and others, in the April 2009 Archives of Physical Medicine and Rehabilitation 90, pp. 560-563.
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