Disparities in Utilization of Outpatient Rehabilitative Care Following Hip Fracture Hospitalization With Respect to Race and Ethnicity

Abstract Nguyen-Oghalai TU, Ottenbacher KJ, Kuo Y-F, Wu H, Grecula M, Eschbach K, Goodwin JS. Disparities in utilization of outpatient rehabilitative care following hip fracture hospitalization with respect to race and ethnicity. Objective To compare the prevalence of discharge home to self-care after hip fracture hospitalization among the elderly in 3 racial groups: whites, Hispanics, and blacks. Design Secondary data analysis. Setting US hospitals. Participants Patients (N=34,203) aged 65 and older with Medicare insurance discharged after hip fracture hospitalization between 2001 and 2005. Interventions Not applicable. Main Outcome Measure Discharge home to self-care. Results Bivariate analyses showed higher rates of discharge home to self-care among minorities, 16.4% for Hispanics, 8.7% for blacks, and 5.9% for whites. Hispanics had 3-fold higher odds of being discharged home to self-care, and blacks had about 50% higher odds of being discharged home to self-care after adjusting for age, sex, Klabunde's comorbidity index, income, year of admission, type of hip fracture, surgical stabilization procedure, and length of hospital stay. Conclusions The higher rate of discharge home to self-care among minorities underscores the risk of suboptimal outpatient rehabilitative care among minorities with hip fracture.