Rd. Horner et al., RACIAL-DIFFERENCES IN THE UTILIZATION OF INPATIENT REHABILITATION SERVICES AMONG ELDERLY STROKE PATIENTS, Stroke, 28(1), 1997, pp. 19-25
Background and Purpose We undertook this study to ascertain whether el
derly black and white patients who are hospitalized for stroke utilize
inpatient physical and occupational therapy (PT/OT) services differen
tly, adjusting for characteristics associated with use of these servic
es. Methods We retrospectively reviewed medical records regarding the
care received by a nationally representative sample of 2497 black and
white Medicare patients, aged 65 years or older, who were hospitalized
at any of 297 acute-care hospitals located in 30 communities within f
ive states. Results Compared with whites, black stroke patients were y
ounger and more likely to have Medicaid coverage, have an ischemic str
oke, and have a motor deficit noted at the time of admission. There wa
s no difference in either sex or level of consciousness on admission.
Overall, a larger proportion of black stroke patients used inpatient P
T/OT at some point during the hospitalization (66.3% versus 55.8%; P<.
01). However, after adjustment for characteristics associated with use
of PT/OT, there was no racial difference in either the likelihood of
inpatient PT/OT use (adjusted relative risk, 1.06; 95% confidence limi
ts, 0.89 to 1.27; P=.42) or time to initial contact (median: blacks, 6
.6 days; whites, 7.4 days; P=.42). Adjusted analyses also indicated a
similarity between the racial groups in the number of inpatient PT/CT
days overall or as a proportion of the hospital stay. Conclusions Elde
rly black and white stroke patients who have Medicare coverage have si
milar patterns of use of inpatient PT/OT services.