Racial/ethnic and insurance status disparities in discharge to posthospitalization care for patients with traumatic brain injury

Wendy G. Kane, Dagan A. Wright, Rongwei Fu, Kathleen F. Carlson

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Objectives: Professional, posthospitalization care (PHC) can improve outcomes among patients with traumatic brain injury. We examined disparities in discharge to PHC by patients' race/ethnicity and insurance type.

A total of 6061 adults hospitalized for unintentional traumatic brain injury in Oregon, 2008 to 2011.

Posthospitalization care was assessed on the basis of discharge disposition. Multivariable logistic regression was used to estimate effects of race/ethnicity and insurance on referral to PHC while controlling for potential confounders. Generalized estimating equations were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), accounting for clustering of data by hospital.

28% of patients were discharged to PHC.While controlling for potential confounders, Hispanics were less likely to be discharged to PHC (OR, 0.62; CI, 0.40-0.96) than non-Hispanic whites. Compared with patients with private insurance, uninsured patients were less likely to be discharged to PHC (OR, 0.19; CI, 0.11-0.32) whereas patients with public insurance (OR, 1.65; CI, 1.33-2.05) and worker's compensation (OR, 1.66; CI, 1.09-2.52) were more likely to be discharged to PHC.

Results suggest that racial/ethnic and insurance disparities exist in discharge to postacute care after hospitalization for traumatic brain injury. Future research should examine factors that might contribute to and reduce these inequities in care.

Original languageEnglish (US)
Pages (from-to)E10-E17
JournalJournal of Head Trauma Rehabilitation
Volume29
Issue number6
DOIs
StatePublished - Dec 10 2014

Keywords

  • Discharge disposition
  • Ethnicity
  • Healthcare disparities
  • Insurance
  • Race
  • Traumatic brain injury

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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