Brian R. Englum|Cassandra V. Villegas|Oluwaseyi Bolorunduro|Elliott R. Haut|Edward E. Cornwell|David T. Efron|Adil H. Haider
Racial, Ethnic, and Insurance Status Disparities in Use of Posthospitalization Care after Trauma
Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine|Howard University|Johns Hopkins University|Johns Hopkins Medicine|Howard University|Johns Hopkins University|Johns Hopkins Medicine|Johns Hopkins University|Johns Hopkins Medicine
background posthospitalization care important recovery trauma disadvantaged populations like racial ethnic minorities uninsured make substantial percentages trauma patients use posthospitalization facilities unknown study design study analyzed national trauma data bank admissions 2007 18 64yearolds estimated relative risk ratios rrr discharge posthospitalization facilitieshome home health rehabilitation nursing facilityby race ethnicity insurance multinomial logistic regression adjusted patient characteristics including age sex injury severity score mechanism injury length stay among others results 136239 patients met inclusion criteria data analysis patients discharged home 789 fewer went home health 33 rehabilitation 50 nursing facilities 54 compared white patients adjusted analysis relative risk ratios discharge rehabilitation 061 95 ci 056 066 044 95 ci 040 049 blacks hispanics respectively compared privately insured white patients hispanics lower rates discharge rehabilitation whether privately insured rrr 045 95 ci 040 052 publicly insured rrr 051 95 ci 042 061 uninsured rrr 020 95 ci 017 024 black patients similarly low rates private rrr 063 95 ci 056 071 public rrr 072 95 ci 063 082 uninsured rrr 027 95 ci 023 032 relative risk ratios discharge home health nursing facilities showed similar trends among blacks hispanics regardless insurance except black patients insurance whose discharge nursing facilities similar white counterparts conclusions disadvantaged populations limited use posthospitalization care rehabilitation trauma suggesting potential improvement trauma care underprivileged