Faculty Collaboration Database

Racial/ethnic disparities in poststroke outpatient rehabilitation among veterans. J Natl Med Assoc 2010 Sep;102(9):817-22

Date

10/07/2010

Pubmed ID

20922926

DOI

10.1016/s0027-9684(15)30679-9

Scopus ID

2-s2.0-77957966757 (requires institutional sign-in at Scopus site)   4 Citations

Abstract

OBJECTIVE: To examine racial/ethnic differences in the use of poststroke outpatient rehabilitation in veterans.

METHODS: We examined data from 4115 veterans with a diagnosis of stroke who were seen at a VA Medical Center in the southeastern United States. We compared the receipt of physical therapy (PT) and occupational therapy (OT) evaluations, visits, and procedures among 3 racial/ethnic groups. Multiple logistic regression was used to assess the independent effect of race/ethnicity on the receipt of a PT or OT evaluation and Poisson regression to estimate the effect of race/ethnicity on treatment visits and procedures received.

RESULTS: In univariate comparisons, a higher proportion of blacks received PT and OT evaluations than whites and others. Similarly, blacks received a higher mean number of PT/ OT treatments than whites and others. In multivariate logistic models with whites as reference, blacks were more likely to receive PT evaluations (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.24-1.74) and OT evaluations (OR, 1.23; 95% CI, 1.01-1.51). In multivariate Poisson models with whites as reference, blacks received more PT/OT visits (OR, 7.22; 95% CI, 5.95-8.76) than non-Hispanic whites (OR, 5.28; 95% CI, 4.41-6.33), while others received fewer visits (OR, 4.39; 95% CI, 3.58-5.39) than the reference group. No significant differences were observed across groups in the number of procedures completed during each treatment visit.

CONCLUSIONS: In an equal-access system, blacks were more likely to receive outpatient PT/OT evaluations and higher mean number of PT/OT treatments. Future studies need to examine sociodemographic and disease-specific factors that account for these differences.

Author List

Ellis C, Zhao Y, Egede LE

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Female
Humans
Male
Middle Aged
Multivariate Analysis
Occupational Therapy
Odds Ratio
Physical Therapy Specialty
Stroke
Stroke Rehabilitation
United States
Veterans