Racial disparities in post-discharge healthcare utilization after trauma.
Adult
Black or African American
Aged
Boston
/ epidemiology
Facilities and Services Utilization
/ statistics & numerical data
Female
Health Services Accessibility
/ statistics & numerical data
Healthcare Disparities
/ ethnology
Humans
Injury Severity Score
Logistic Models
Male
Middle Aged
Patient Acceptance of Health Care
/ ethnology
Patient Discharge
Trauma Centers
White People
Wounds and Injuries
/ ethnology
Long-term outcomes
Patient-reported
Post-discharge
Racial disparities
Rehabilitation utilization
Trauma
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
28
02
2019
revised:
18
03
2019
accepted:
23
03
2019
pubmed:
8
4
2019
medline:
4
3
2020
entrez:
8
4
2019
Statut:
ppublish
Résumé
Racial disparities in trauma outcomes have been documented, but little is known about racial differences in post-discharge healthcare utilization. This study compares the utilization of post-discharge healthcare services by African-American and Caucasian trauma patients. Trauma patients with an Injury Severity Score (ISS)≥9 from three Level-I trauma centers were contacted between 6 and 12 months post-injury. Utilization of trauma-related healthcare services was asked. Coarsened exact matching (CEM) was used to match African-American and Caucasian patients. Conditional logistic regression then compared matched patients in terms of post-discharge healthcare utilization. 182 African-American and 1,117 Caucasian patients were followed. Of these, 141 African-Americans were matched to 628 Caucasians. After CEM, we found that African-American patients were less likely to use rehabilitation services [OR:0.64 (95% CI:0.43-0.95)] and had fewer injury-related outpatient visits [OR:0.59 (95% CI:0.40-0.86)] after discharge. This study shows the existence of racial disparities in post-discharge healthcare utilization after trauma for otherwise similarly injured, matched patients.
Sections du résumé
BACKGROUND
Racial disparities in trauma outcomes have been documented, but little is known about racial differences in post-discharge healthcare utilization. This study compares the utilization of post-discharge healthcare services by African-American and Caucasian trauma patients.
METHODS
Trauma patients with an Injury Severity Score (ISS)≥9 from three Level-I trauma centers were contacted between 6 and 12 months post-injury. Utilization of trauma-related healthcare services was asked. Coarsened exact matching (CEM) was used to match African-American and Caucasian patients. Conditional logistic regression then compared matched patients in terms of post-discharge healthcare utilization.
RESULTS
182 African-American and 1,117 Caucasian patients were followed. Of these, 141 African-Americans were matched to 628 Caucasians. After CEM, we found that African-American patients were less likely to use rehabilitation services [OR:0.64 (95% CI:0.43-0.95)] and had fewer injury-related outpatient visits [OR:0.59 (95% CI:0.40-0.86)] after discharge.
CONCLUSIONS
This study shows the existence of racial disparities in post-discharge healthcare utilization after trauma for otherwise similarly injured, matched patients.
Identifiants
pubmed: 30954233
pii: S0002-9610(19)30306-X
doi: 10.1016/j.amjsurg.2019.03.024
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
842-846Informations de copyright
Copyright © 2019. Published by Elsevier Inc.