Ethnic Differences in Postacute Stroke Rehabilitation.
Imadeddin Hijazi, Amanda Malingagio, Emily Anderson and 3 others
PMID 41276209WHAT IT FOUND
After adjusting for income, education, and other factors, there was no clear difference in first inpatient rehab use between MA and NHW stroke survivors.
Before adjustment, NHW use was higher.
Key findings
01In the unadjusted analysis of 974 rehab participants, NHW patients were 7.4 percentage points more likely than MA patients to use IRF as the first rehabilitation provider (P=.028).
02After PS adjustment, the difference in IRF as the first provider was 1.6% and was not statistically significant (P=.687).
03Most of the attenuation came from socioeconomic factors, and education alone accounted for a roughly 55% reduction in the ethnicity effect size.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was done in one county with a large MA population, so it may not apply to other communities. The study did not measure poststroke function before 90 days, so it cannot show whether the rehabilitation setting changed recovery. The sample was too small for subgroup analyses. In-hospital complications were identified from ICD-10 codes, which may not be completely reliable. The transition analyses were descriptive and limited, so their clinical effect is unclear. The adjusted confidence interval was wide (95% CI, -6.1 to 9.2), so the study cannot rule out some difference. The study cannot show why the unadjusted ethnic difference occurred.
The easy way to misread this
Do not read the adjusted 1.6% difference as proof that the ethnic difference is absent; it was not statistically significant (P=.687) and the unadjusted difference was 7.4 percentage points (P=.028). Do not infer that IRF improves function, because the study did not measure poststroke functional status before 90 days.