Inpatient rehabilitation facility discharge destination among younger adults with traumatic brain injury: differences by race and ethnicity.
Tolu O Oyesanya, Gabrielle Harris, Qing Yang and 4 others
PMID 33779428WHAT IT FOUND
After inpatient rehab, Hispanic/Latino patients and patients of other race/ethnicity were more likely than White patients to go home rather than subacute care.
Black patients did not differ. Predictors varied by group and explained little.
Key findings
01Among 99,614 younger adults in the IRF sample, 89.24% were discharged to home/community and 10.76% to subacute settings.
02After adjustment, Hispanic/Latino patients had higher odds of discharge home versus subacute compared with White patients (OR=1.26; 95% CI: 1.15, 1.37), and patients of other race/ethnicity had higher odds (OR=1.10; 95% CI: 1.00, 1.21); Black patients did not differ.
03Living with family/relatives before admission was a strong predictor of discharge home, especially for patients identifying as other race/ethnicity (OR=3.30; 95% CI: 2.65, 4.13), and the subgroup models explained little variance (R2 range 0.12-0.17).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study used registry data and did not include the acute care hospital stay or health status after IRF discharge. It did not measure injury severity, broader social determinants, or quality of care, which can affect discharge. Unmeasured factors could have influenced the results. The models explained little variance, so the variables studied did not account for much of the discharge destination. Admission and discharge FIM differences were statistically significant but not clinically meaningful. The paper says the reason for racial/ethnic differences in discharge destination is unclear.
Declared interests
The authors declared no conflicts of interest. The paper is marked as supported by NIH extramural research funding.
The easy way to misread this
Do not read discharge home as proof of better recovery or equitable care. The study did not measure post-IRF health, injury severity, or quality of care, and the models explained little of the discharge destination.