PTCohortArchives of physical medicine and rehabilitation2019

Racial Differences in Discharge Location After a Traumatic Brain Injury Among Older Adults.

Aparna Vadlamani, Justin A Perry, Maureen McCunn and 2 others

PMID 30954440

WHAT IT FOUND

Black patients were more likely than white patients to be discharged to inpatient rehabilitation rather than home without services after accounting for age, sex, insurance, comorbidities, and injury severity.

Without that accounting, the race difference was not significant.

Key findings

01Black patients were more likely than white patients to be discharged to inpatient rehabilitation rather than home after adjustment for pre and post TBI variables.

02In the final sample, 1,513 patients were discharged to inpatient rehabilitation and 1,389 were discharged home without services.

03Sensitivity analyses restricting to Medicare beneficiaries or excluding mild head injury did not materially change the race discharge association.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

Read the rest of this summary

You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.

Already have one?

What it does not show

The analysis used registry data from a single urban trauma center, so its discharge patterns may not match other hospitals. It did not measure social support, socioeconomic status, or disability, which may explain part of the race difference. It excluded people discharged to locations other than inpatient rehabilitation or home without services, so it does not describe all discharge outcomes. It could not measure severity of comorbidities or time from injury to admission.

Declared interests

The article is listed as supported by NIH and U.S. government P.H.S. research funding. The text provided does not include a conflict of interest declaration.

The easy way to misread this

Do not read this as evidence that black patients need more rehabilitation or that clinicians chose inpatient rehabilitation because of race. The paper reports only an adjusted association in discharge location. It did not measure social support, disability, or detailed comorbidity severity, and the unadjusted race comparison was not significant.

Read it on PubMed →