Racial/Ethnic Differences in FIM??? Scores and Length of Stay for Underinsured Patients Undergoing Stroke Inpatient Rehabilitation

Chiou‐Tan, Faye Y.; Keng, Moses J.; Graves, Daniel E.; Chan, Kwai-Tung; Rintala, Diana H.

doi:10.1097/01.phm.0000214320.99729.f3

Cited by 36 publications

(31 citation statements)

References 11 publications

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“…26 The patient sociodemographic and clinical variables were selected on the basis of the literature, preliminary screen, and clinical expertise. A review of the literature revealed the following variables that could assist in predicting disposition: the FIM, particularly the motor FIM [27][28][29][30][31] ; stroke severity, most often measured by the National Institutes of Health Stroke Scale 32-34 ; racial background [22][23][24]35 ; age at stroke onset 17,36 ; marital status 30 ; and insurance. 37 The team of clinicians and researchers further evaluated the data available for variable selection.…”

Section: Data Collectionmentioning

confidence: 99%

“…12,17,18 There is little information on which specific patient characteristics can be used to predict a home versus institution disposition from inpatient rehabilitation. [19][20][21][22][23][24] The purpose of this study was to examine sociodemographic and clinical characteristics independently associated with discharge home compared with discharge to a skilled nursing facility (SNF) after acute inpatient rehabilitation.…”

mentioning

confidence: 99%

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Factors Associated With Discharge to Home Versus Discharge to Institutional Care After Inpatient Stroke Rehabilitation

Nguyen

Prvu‐Bettger

Guerrier

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Section: Data Collectionmentioning

confidence: 99%

mentioning

confidence: 99%

Factors Associated With Discharge to Home Versus Discharge to Institutional Care After Inpatient Stroke Rehabilitation

Nguyen

Prvu‐Bettger

Guerrier

et al. 2015

Archives of Physical Medicine and Rehabilitation

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“…This finding was consistent among black or African American and white patients, but only 10.6% of black or African American patients had a neurologist as their attending physician compared with 20.3% of white patients. 152 Thus, this study indicates a discrepancy in delivery of care with possible direct consequences on treatment and patient outcome.…”

Section: Differential Referral To Neurologistsmentioning

confidence: 99%

“…A retrospective cohort study found no racial-ethnic differences in admission FIM scores, 151 whereas others found significant differences in FIM scores. One study of a large urban county hospital reported that Hispanics had lower admission FIM scores than blacks or African Americans, 152 and another study found that unadjusted FIM scores were highest for whites compared with other racial groups. 153 A few studies reported no racial-ethnic differences in length of stay for inpatient rehabilitation [151][152][153] ; however, 1 study of Veterans Affairs (VA) and non-VA inpatient rehabilitation facilities reported significantly longer average lengths of stay for blacks or African Americans than for whites.…”

Section: Disparities In Access To Stroke Rehabilitationmentioning

confidence: 99%

Racial-Ethnic Disparities in Stroke Care: The American Experience

Cruz‐Flores¹,

Rabinstein²,

Biller³

et al. 2011

Stroke

423

261

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Purpose-Our goal is to describe the effect of race and ethnicity on stroke epidemiology, personal beliefs, access to care, response to treatment, and participation in clinical research. In addition, we seek to determine the state of knowledge on the main factors that may explain disparities in stroke care, with the goal of identifying gaps in knowledge to guide future research. The intended audience includes physicians, nurses, other healthcare professionals, and policy makers. Methods-Members of the writing group were appointed by the American Heart Association Stroke Council Scientific Statement Oversight Committee and represent different areas of expertise in relation to racial-ethnic disparities in stroke care. The writing group reviewed the relevant literature, with an emphasis on reports published since 1972. The statement was approved by the writing group; the statement underwent peer review, then was approved by the American Heart Association Science Advisory and Coordinating Committee. Results-There are limitations in the definitions of racial and ethnic categories currently in use. For the purpose of this statement, we used the racial categories defined by the US federal government: white, black or African American, Asian, American Indian/Alaskan Native, and Native Hawaiian/other Pacific Islander. There are 2 ethnic categories: people of Hispanic/Latino origin or not of Hispanic/Latino origin. There are differences in the distribution of the burden of risk factors, stroke incidence and prevalence, and stroke mortality among different racial and ethnic groups. In addition, there are disparities in stroke care between minority groups compared with whites. These disparities include lack of awareness of stroke symptoms and signs and lack of knowledge about the need for urgent treatment and the causal role of risk factors. There are also differences in attitudes, beliefs, and compliance among minorities compared with whites. Differences in socioeconomic status and insurance coverage, mistrust of the healthcare system, the relatively limitedThe findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.The American Heart Association makes every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on April 6, 2011. A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@woltersklu...

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“…In direct contrast, Berges et al noted significant differences at 3 months post injury while finding no significant differences at discharge [7]. When examining change over time, another study observed that whites demonstrated greater overall gains in FIM total and cognitive scores from admission to discharge [8], although once admission FIM scores were statistically accounted for, these significant racial/ethnic differences in post-acute rehabilitation outcomes were eliminated [9][10][11][12].…”

Section: Differences In Rehabilitation Outcomementioning

confidence: 76%

Race and Post-acute Stroke Recovery: More Similarities than Differences

Perna¹

2017

Phys Med Rehabil Int

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Race is a significant variable in terms of some health outcomes. Research has produced mixed findings in regards to the influence of race membership and rehabilitation outcomes from cardiovascular insults. More extensive research focused on traumatic brain injury (TBI) has found significant racial differences in post-injury recovery outcome. Stroke rehabilitation research has noted similar findings. However, such differences in functional outcomes were largely predicted by demographic characteristics such as age, education, and socioeconomic status, as well as injury and environmental parameters. The current archival study compared rehabilitation outcomes across two demographically comparable racial/ethnic groups (i.e., Whites of non-Hispanic origin, and Blacks) with a hypothesis that in a sample that does not widely vary in key demographic confounds (age, education, premorbid job status, substance use), there may still be significant racial differences in rehabilitation outcomes. The participants included 317 individuals (White = 224, Black = 93) who had suffered a cerebrovascular incident (CVA) within three months prior to initiating rehabilitation at an urban outpatient multidisciplinary brain injury rehabilitation program. The two racial groups were comparable in terms of mean age (46.3 vs. 48.3), education level (14.4 vs. 15.4), premorbid employment (76.9% vs. 74.2%), and substance use (19% vs. 21.9%), as well as disability severity as measured by admission Mayo Portland Adaptability Inventory (44.6 vs. 45.9). Admission MPAI-4 scores revealed that both groups began treatment with mild limitations in the areas of ability and adjustment as well as mild to moderate interference with community participation. Comparative data via ANOVA indicated that although both groups appeared to have significantly benefitted from rehabilitation, there were no statistically significant differences in the discharge MPAI scores between the two groups. The two groups also did not significantly differ with regard to the MPAI change scores (admission minus discharge). Results suggest that early (within six months post CVA) rehabilitation outcomes measured by MPAI-4 are far more similar than different for these two racial groups, when the groups are comparable on key demographic variables. These findings are consistent with previous research on the topic. Limitations of this study include higher than average educational level of participants, limited outcome measures, and limited racial representation.

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Racial/Ethnic Differences in FIM??? Scores and Length of Stay for Underinsured Patients Undergoing Stroke Inpatient Rehabilitation

Cited by 36 publications

References 11 publications

Factors Associated With Discharge to Home Versus Discharge to Institutional Care After Inpatient Stroke Rehabilitation

Factors Associated With Discharge to Home Versus Discharge to Institutional Care After Inpatient Stroke Rehabilitation

Racial-Ethnic Disparities in Stroke Care: The American Experience

Race and Post-acute Stroke Recovery: More Similarities than Differences

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